Tuesday, June 14, 2016

Breaking: Mindoula Health Acquires Care at Hand

Purchase broadens Mindoula’s behavioral health case management and technology suite

June 14, 2016 - Silver Spring, MD - Mindoula Health, a technology-enabled case management company at the forefront of the transformation of behavioral healthcare, today announced the acquisition of San Francisco-based Care at Hand. Care at Hand’s predictive insights platform will significantly enhance Mindoula’s ability to prevent hospital admissions.

Care at Hand, one of the first companies accepted into StartUp Health Academy’s GE Program, is the developer of a predictive insights platform powered by non-medical staff. The technology uses smart surveys to identify early medical and psychosocial risk factors for hospitalization. Unlike episodic predictive models limited to claims and EMR data, Care at Hand predicts hospitalization risk in the blind spot between doctor visits using the observations of frontline staff.

“Care at Hand stood out from other digital health companies because of the impressive body of research validating their impact with notable studies showing risk prediction up to 120 days (AHIMA 2016), $9,056 in Medicare A savings per beneficiary per year (Avalere 2015) and a 39.6% reduction in readmissions (AHRQ 2014)” noted Steve Sidel, Founder & CEO of Mindoula.

“The Care at Hand team is thrilled to join forces with Mindoula in a way that will allow us to extend our mission to help people thrive in their homes and avoid hospitalizations,” says Dr. Andrey Ostrovsky, the co-founder and CEO of Care at Hand, who will be joining Mindoula as the SVP of Medical Affairs.

The addition of Care at Hand technology will expand the reach of Mindoula’s market-leading case management solutions to the full continuum of care-team members creating unprecedented cost-effectiveness and quality of behavioral healthcare.

“We have dedicated our company to transforming what we see as a broken behavioral health system,” said Steve Sidel.  “Our case managers and peer support specialists leverage our multi-platform technology to provide around the clock behavioral health support that is person-centered and evidence-based.  The Care at Hand acquisition optimizes our technology-enabled services and makes them indispensable to providers and payers participating in value based delivery models.”

About Mindoula

Mindoula Health (www.mindoula.com) is a technology-enabled case management company headquartered in Silver Spring, Maryland, that provides 24/7 virtual and in-person support to individuals and families facing behavioral health challenges.  Its proprietary telehealth platform which includes a HIPAA compliant mobile engagement app, proprietary psychometrics, predictive analytics, and collaborative care software, enables its team of case managers and peer support specialists to deliver market leading behavioral health outcome improvements and reduce healthcare costs.  A leader in the areas of case management, collaborative care, and behavioral health population management, Mindoula is at the forefront of the transformation of behavioral healthcare.

Contact:  Kristi Stovall
Mindoula Health
1117 East-West Hwy
Sliver Spring, MD 20910
Phone: (301) 335-6055

Thursday, March 3, 2016

From VSee - Care at Hand: Proving the ROI of Telemedicine


There is a lot of hype about telemedicine. As the reimbursement landscape matures due to the Medicare Access and CHIP Reauthorization Act (MACRA) and other policy vehicles, the promise of telemedicine is being put to the test.


The good news is that telemedicine has been shown to be clinically effective and financially sustainable in certain settings. However, telemedicine is not always clinically appropriate or commercially viable. It requires a graded approach in each clinical situation in order to

  • balance specific patient needs and risks,
  • complement the local care delivery processes, and
  • align with local healthcare financing environment.

As a pioneer in telemedicine, VSee is partnering with Care at Hand to deliver telehealth that continually titrates the level telemedicine as needed to optimize clinical outcomes, patient experience, and cost effectiveness. Click here to read more from VSee.

Monday, February 8, 2016

Speeding Up Impact with The Mayo Clinic THINK BIG Challenge and Care at Hand




Thirty-seven million people are discharged from hospitals each year. Imagine being one of those people that are 73 years old, exhausted from the recent hospital admission, scared about how you're going to pay for your hospital bills, embarrassed to ask your children for help, and fearing if the next admission is your last. Too many people are physically, emotionally, and psychologically suffering from avoidable admissions for innovation to happen inefficiently. That's why catalysts like the Mayo Clinic Think Big challenge are so crucial to the innovation ecosystem.

Winning the Mayo Clinic Think Big Challenge has been an important catalyst for Care at Hand as reflected by our doubling customer base in the last 9 months. Part of that growth comes from the great synergy between the publicity from winning the challenge and the maturation of our distribution channels. One of our biggest distribution partners, Public Consulting Group, has been using Care at Hand to differentiate itself from the competition by complementing its administrative services as a fiscal intermediary with our technology’s ability to support risk prediction and population health management. We have a pipeline of five distribution partners in the home health care and hospital space that we’re excited to announce in the coming quarter. We welcome other solution providers that would like to expand their offering to non-medical staff.

To keep up with growing demand, we streamlined the education of interested organizations with the launch of our new website on Jan 17th.

In addition to boosting our customer growth, winning the Think Big Challenge has increased the recognition for our research. Notably, we recently published a research study in the AHIMA perspectives journal which showed the derivation and validation of our risk-prediction models. The study had some exciting findings including:

  • Non-medical workers using Care at Hand could be used to predict hospitalizations out to 120 days
  • Hospitalization risk factors aren’t just limited to medical causes, but rather 38% of elevated risk episodes included upstream health determinants
  • Nurses are required to adequately address elevated risk alerts, but nurses don’t have to be on the frontline of care and can instead be in a supervisory role

Another big study that has gained distribution through the Mayo-Avia network has been a paper published in Annals of Long Term Care which provided a prescription for how non-medical workers can be more optimally incorporated into bundled payment delivery models. We’re also excited to announce in the coming month that one of our research collaborators has been funded to do a randomized-controlled trial of our technology in a Medicaid population. This study will be a seminal exploration of healthcare delivery innovation for some of the most vulnerable populations.

Any researchers interested in joining the growing community of academics exploring innovative applications and implications of Care at Hand, please see our research page for more details and to view existing research partners.

In the coming months, we’re staffing up to serve our growing customer base and welcome supporters like Mayo Clinic and Avia that can help fuel our growth further.


Saturday, January 30, 2016

Challenges facing Accountable Communities RFP

CMS recently issued an innovative and pioneering funding mechanism to implement the Accountable Health Communities model of care. The funding was promising with $157M committed to be distributed among 44 awards. Since announcement of the funding opportunity, home and community based services (HCBS) providers have identified some major limitations to the funding announcement. The following are significant concerns raised by HCBS providers in our network that may inform how this and future funding opportunities may evolve to better meet the needs and grow the potential of community providers to contribute to the Triple Aim.

No funds for providing social service support
The RFP is very clear that none of the demonstration funds can be used to provide social services to patients. Many of the gaps in home and community-based services stem from adequate financial support and alignment, so lack of direct funding for these supports is a major limitation of the Accountable Communities RFP.

Misalignment with current practice workflows
Although admirable and justified in some cases, the requirement for randomization of interventions at the individual patient level in Tracks 1 & 2 would make it prohibitively difficulty to implement an evaluation within the constraints of current practices. A mixed methods approach may be more appropriate for evaluation here.

Consequently, Track 3 has been identified as the most attractive of the three tracks available. A major limitation of Track 3 is that partnering clinical sites would be expected to implement a “universal screening” of social service needs for Medicare & Medicaid beneficiaries, but wouldn’t get resources from this demo to do that screening for everyone in their practice. 

Another limitation of Track 3 is that the community provider is expected to identify “high-risk” patients defined as those having 2 or more ED visits in the past year. Population segmentation based on acute care utilization becomes challenging for community providers because they typically do not have access to claims data. Some states have HIEs that offer connectivity to community providers, but privileges to access utilization data are largely limited to hospital providers in most cases.

An additional misalignment with existing provider workflow and Track 3 is the requirement to offer navigation services only to those patients identified as high-risk. This constraint is unrealistic because consumers with fewer than 2 ED visits may still warrant navigation support but such services would not be within scope of the RFP.

Requirement for high patient numbers
The RFP outlines a requirement that recipients see and screen at least 75,000 Medicare & Medicaid beneficiaries per year in a given geographic region, for each year of the 5-year demonstration. That distills to 6250 patients per month or about 1565 per week or 313 patients per day. Since Medicare & Medicaid typically only make up less than 40 to 50% of the practice population for most practices, for providers to qualify for this RFP they would need to have a volume of about 600 patients per day. Typical small practices see closer to about 50 to 100pts per day. To quality, there would need to be enough organization to coordinate at least 8 practices to agree to participate in a given geographic region, which is challenging, especially in rural areas.

Insufficient resources to run the project 
While the “Track 3” option offers $4.5M for the 5 year period of the demonstration, that averages to only $900,000 per year. That is a low amount relative to the large opportunity cost including building and identifying data systems to track and report very specific, patient-level data to CMS for a minimum 75,000 Medicaid & Medicare beneficiaries per year; developing and maintaining a community resource directory for each community, presumably paying staff on the clinical side to do the social service screenings; paying for staff to do referrals and provide navigation services to “high risk” patients; and providing quality improvement services; reporting to CMS, among others.

Need for state Medicaid engagement  
While the requirement to get agreement from the state Medicaid agency to partner on this is understandable, it could present a significant challenge, particularly getting enough of their bandwidth to meet the requirement for them to provide ongoing data reporting to CMS.

Although the intent of this RFP is great, many HCBS providers find that this RFP is not a good fit for them given the limitations above.