Welcome to Part 3 of “What is Hybrid Cardiac Rehab?”, where we make the business case for Hybrid Cardiac Rehab by laying out out the direct and indirect costs associated with a Hybrid Cardiac Rehab Program. Check out Part 1 to learn about patient types and Part 2 for staffing requirements and day to day operations.

Barriers to the Effectiveness of Center-based Cardiac Rehab
In-person CR works wonderfully when patients are mobile, live close to the CR center, and have flexible schedules; but there are many patients whose living situations do not fit this framework. This is in part why 80% of the patients who need CR are unable to participate and complete their program. These low participation rates limit in-person CR’s effectiveness as a post-acute readmission reduction strategy.

Hybrid rehab programs can plug this gap - by implementing hybrid rehab programs, programs and practices could serve more patients at a higher convenience. As mentioned in Part 1, Hybrid Cardiac Rehab compliments center-based approaches by allowing patients to complete some or all of their rehab at home depending on their risk stratification. Hybrid Cardiac Rehab increases program capacity without the need for physical expansion.

Hybrid Cardiac Rehab helps solve the problem of access and care in two ways. In a hybrid approach, a single care manager can serve 300 patients a year. Home-based programs have also historically shown greater than 50% uptake. Thus for a typical hospital, a rehab program could double its capacity by adding a single staff member.

As encouraging as the outcomes for Hybrid cardiac rehab are; decision makers cannot adopt telehealth without a return on investment. In a Hybrid Cardiac Rehab Program, the increased number of patients provides a return on investment in the form of additional revenue through reimbursements or through direct and indirect cost savings from prevention of ED visits and readmissions.

Direct Revenue from Reimbursement
Reimbursement of home-based sessions for remote cardiac rehab depends on telemedicine Parity laws in your hospital’s state. Using the format described in Part 2, a hospital could earn up to $1,200 dollars per patient. At 300 patients, this translates to $360,000 in revenue per year.

For more information about how Parity law could apply to your hospital, read our article titled “Securing Reimbursement for Virtual Cardiac Rehab.”

Cost Savings
Hospitals that hold risk-based contracts with payers can lower direct and indirect costs of cardiac rehab by adopting Hybrid Cardiac Rehab.

Direct cost savings - For risk-bearing providers, Hybrid Cardiac Rehab is a more cost-effective alternative to brick and mortar based care. The savings breaks down as follows:

As can be seen, implementing a hybrid program for a patient population of 300 can result in savings of $900,000.

Indirect cost savings - Hospitals with a Hybrid Cardiac Rehab Program can expect to triple participation rates. With three times as many patients receiving the benefits of cardiac rehabilitation, readmissions and unnecessary emergency department visits will be reduced. Savings generated from preventable readmissions is as follows:

As can be seen, implementing a hybrid program can result in significant indirect cost savings through readmission prevention.

Conclusion
Hybrid Cardiac Rehab is an effective way to raise CR participation and completion rates. Hybrid CR increases program capacity without the need to expand facilities, is minimally disruptive to operations during implementation and provides significant direct and indirect cost savings when compared to traditional CR. Hybrid Cardiac Rehab’s software platform enhances patient/provider communication and allows for remote monitoring and management of patient populations.

Check out our other articles on Feats in Heartbeats for more information from thought leaders in CR and methods to optimizing CR processes.

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