Team Select Home Care has launched a predictive analytics platform that has quickly paid off with a significant reduction in hospitalizations.
The AI platform, called CareSightAI, is a multi-million-dollar, years-long project that the company’s CEO hopes will be a catalyst for a new level of value-based care contracting and improve hospitalization rates for pediatric respiratory patients.
Rather than trying to address several conditions from the outset, Team Select Home Care CEO and President Fred Johnson explained that it was important for the company to begin by focusing on a specific patient population for their first foray into predictive AI.
“That’s because the same vitals that might cause a cardiac patient to present to the hospital, or ED, are different for a respiratory patient,” he told Home Health Care News.
Phoenix-based Team Select Home Care serves the medically complex pediatric population and seniors in the home. The company operates in 16 states and is one of the largest pediatric long-term care providers in the country. It received a strategic investment from private equity firm Court Square Capital Partners in 2023.
The platform utilizes real-time changes in condition to identify children who are at risk of hospitalization. Ultimately, the company decided to focus on respiratory patients because they represented the highest percentage of hospitalizations among Team Select Home Care patients.
Respiratory patients for the company’s private-duty nursing segment represent 30% of Team Select Home Care’s patients under care, but made up 45% of the company’s pediatric hospitalizations, according to Johnson.
Though Team Select Home Care recently launched CareSightAI, the company began planting the seeds for the platform 11 years ago when it established a clinical data warehouse.
“We have over a decade’s worth of internal data with which to use for this model,” Johnson said. “We also, of course, blended data from external parties where it made sense as well.”
While Johnson describes the platform as continuously learning and improving, he also stresses that the AI tool is not a stand-in for clinical decision-makers.
“The tool is simply a product to help enable our clinicians to make better and faster decisions,” he said. “The tool itself will never replace clinical decision-making whatsoever. It can detect things like respiratory rates, and things that might be very difficult for a clinician to see at a deep level.”
Benefits of predictive analytics
Johnson predicts that CareSightAI will allow Team Select Home Care to significantly reduce hospitalization. Since the company fully deployed the tool across 16 states and roughly 60 locations, it has already made a clear impact.
“We have not had a single respiratory patient hospitalization in the 30 days since we’ve deployed this tool,” Johnson said. “I don’t expect that to continue across thousands of patients, but we’ve seen in only 30 days a significant reduction in hospitalizations. It just kind of goes without saying, in private-duty nursing, our job, above all else, is to keep these kids and adults safe at home, and out of the high-cost settings.”
The opportunity to enter into value-based care contracts was also a key factor in the company’s decision to develop this platform.
“Since these children make up about 0.5% of the Medicaid pediatric population, depending on the study you read, they represent 30% to 40% of all pediatric health care costs,” Johnson said. “Obviously, these kids are a primary focus for payers, as well as us, to try to keep their total cost of care as low as possible.”
Currently, Team Select Home Care has 10 value-based contracts across Texas and Florida, but the company is now renegotiating some of these contracts, leveraging its new tool.
“Generally, the way that we’re approaching it is, ‘We’ll prove it to you,’” Johnson said. “All we’re really asking for is the ability to earn quarterly bonus dollars, or upside reimbursements, for significantly lowering the patient’s hospitalizations, and therefore their total cost of care. For me, this tool gives us the ability to take a new level of risk with value-based contracts.”
Looking ahead, Team Select Home Care plans to expand the tool to address other conditions.
“We’ve already decided we are not going to take a break, as soon as the teams are done rolling this out, over the next four weeks or so, we are going to go immediately into the next diagnosis,” Johnson said.
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