University of Miami Students Aim to Reduce Hospitalizations of Medicare Patients with Heart Failure
Congestive heart failure (CHF), a condition in which the heart can’t pump enough blood to meet the body’s needs, is the most frequent cause of hospitalization of adults 65 and older in the U.S. These patients are among the more than 1 million hospitalized with CHF each year, of which nearly 24% are readmitted within 30 days of being discharged. Readmission of CHF patients older than 65 has become a costly burden on Medicare, a dilemma addressed in the Affordable Care Act (ACA). The ACA mandates incrementally reducing Medicare payments to hospitals with higher-than-expected readmission rates for diseases, including CHF.
Those are the alarming statistics that a foursome of MD/MBA students, who are jointly enrolled in the University of Miami School of Business and Miller School of Medicine, seized upon in their business plan which won a grand prize this spring in the University’s annual Business Plan Competition. The MD/MBA program is one of a number of the UM School of Business health sector programs, which also include an Executive MBA in Health Sector Management and Policy program designed for physicians and others working in the industry.
The MD/MBA students’ company, Valens, is a software service firm that would provide hospitals with a big-data analytic solution to this persistent health care problem. “We were taking MBA classes that include examining big data,” says Mathew Varghese, explaining how he and his teammates — Cristina Del Toro, Sabrina Taldone and Josh Cameron — generated the idea. “Initially we took a broad approach, not sure where we would focus the data.”
“We met with health care executives and practitioners to get their take on what they were doing with IT,” Del Toro says. “We wanted to fix one specific problem,” she explains. The team zeroed in on the dire readmission situation with elderly CHF patients.
Valens seeks to reduce these readmissions by mining patient and hospital data to develop an algorithm that divides CHF patients into various risk categories according to their likelihood of being readmitted. The hospital’s case manager for CHF patients will interface with Valens to prescribe aftercare programs and services for high-risk patients, including nursing care, social workers, transportation to appointments, even phone calls to ensure medications are taken.
“The incentive for hospitals to take more responsibility for CHF patients’ follow-up care after discharge is critical,” says Taldone, whose experience as a consultant for UM’s Launch Pad entrepreneurship center aided the team’s efforts. “The transition of care from hospital to home presents a tremendous business opportunity, but hospitals don’t have enough resources to deal with every CHF patient. That’s where we come in.”
In addition to the dual degree MD/MBA program, the UM School of Business has offered its Executive MBA in Health Sector Management and Policy program for more than 30 years. Classes are held one weekend per month and bring together physicians, nurses, and other experienced health care professionals working in group practices, hospitals, government agencies, pharmaceutical firms, and insurance companies, among other organizations. Combining its strengths in graduate business education and its close relationships with the South Florida health care community, the program teaches practical administrative skills as well as broad strategic and theoretical perspectives to professionals who seek to expand their knowledge of management and administration as applied to the health care industry. The next class begins in January 2015.
More information about the Executive MBA in Health Sector Management and Policy can be found at www.bus.miami.edu/healthUM.