Functional Decline: The Hidden Cost Driver in Medicare Populations
- Monitor patients and identify those with the highest likelihood of readmission from functional decline and/or frailty
- Increase risk adjustment payments for Medicare patients
- Improve outcomes- reduce readmission and hospitalization, improve patient satisfaction
Why Should You Monitor Functional Decline Using Grip Strength?
Underlying Condition: Functional decline impacts over half of Medicare patients10, more than those with cardiovascular conditions(38.6%11) or diabetes (25%12), and individuals with those diseases are more likely to develop functional decline13,14.
Adverse Outcomes: Functional deficits are highly predictive of hospitalization, institutionalization, and mortality. 68% Medicare patients that are hospitalized will be discharged at a functional level lower than when they were admitted15.
Hospital Readmission: Patients with functional impairments are up to 42% more likely to be readmitted than those without16, and to have up to 77% higher healthcare costs in the year post discharge17.
A Strong Predictor: Declining grip strength is proven to be a strong predictor of functional decline, cognitive decline, and frailty2,3,4,18.
Benefits
- identification of decline, paired with early, precision rehab leads to decreased hospitalization.
- early diagnosis of frailty (closely linked to functional decline) leads to increased risk adjustment payments for Medicare patients.
- better care and connection to therapists improves patient satisfaction.
References
10. Damluji, A. A., Chung, S. E., Xue, Q. L., et al. (2021). Frailty and cardiovascular outcomes in the National Health and Aging Trends Study. European Heart Journal, 42(37), 3856-3865.
11. Eberly, L. A., Shultz, K., Merino, M., et al. (2023). Cardiovascular Disease Burden and Outcomes Among American Indian and Alaska Native Medicare Beneficiaries. JAMA Network Open, 6(9), e2334923. doi:10.1001/jamanetworkopen.2023.34923.
12.Andes, L. J., Li, Y., Srinivasan, M., Benoit, S. R., Gregg, E., & Rolka, D. B. (2019). Diabetes Prevalence and Incidence Among Medicare Beneficiaries — United States, 2001–2015. MMWR Morbidity and Mortality Weekly Report, 68, 961–966.
13. Keeney, T., Fox, A. B., Jette, D. U., & Jette, A. (2019). Functional Trajectories of Persons with Cardiovascular Disease in Late Life. Journal of the American Geriatrics Society, 67(1), 37-42. doi: 10.1111/jgs.15584. Epub 2018 Nov 21. PMID: 30460975; PMCID: PMC6705121.
14. Keeney, T., Fox, A. B., Jette, D. U., & Jette, A. (2019). Functional Trajectories of Persons with Cardiovascular Disease in Late Life. Journal of the American Geriatrics Society, 67(1), 37-42. doi: 10.1111/jgs.15584. Epub 2018 Nov 21. PMID: 30460975; PMCID: PMC6705121.
15. Falvey, J. R., Mangione, K. K., & Stevens-Lapsley, J. E. (2015). Rethinking Hospital-Associated Deconditioning: Proposed Paradigm Shift. Physical Therapy, 95(9), 1307-1315.
16. Greysen, S. R., Stijacic Cenzer, I., Auerbach, A. D., & Covinsky, K. E. (2015). Functional impairment and hospital readmission in Medicare seniors. JAMA Internal Medicine, 175(4), 559-565.
17. Greysen, S. R., Stijacic Cenzer, I., Boscardin, W. J., & Covinsky, K. E. (2017). Functional Impairment: An Unmeasured Marker of Medicare Costs for Postacute Care of Older Adults. Journal of the American Geriatrics Society, 65(9), 1996-2002.
18. Duchowny, K. A., Ackley, S. F., Brenowitz, W. D., et al. (2022). Associations Between Handgrip Strength and Dementia Risk, Cognition, and Neuroimaging Outcomes in the UK Biobank Cohort Study. JAMA Network Open, 5(6), e2218314. doi:10.1001/jamanetworkopen.2022.18314.
Able Monitoring
Utilizing Grip Strength Measurement for Home Monitoring of Functional Decline.
Introduce grip strength measurement along with other data points to identify patients in the community that are at the highest risk for functional decline.
Grip Strength Sensor: patients carry out objective grip strength measurements at home using the GripAble sensor on a regular basis.
Patient Reported Outcome Measurements: PROMs are paired with grip measurements to better understand patient decline(eg: PHQ-9, FIM, PSFS).
Able App: All patient data is collected on a mobile app to create patient ownership and understanding of their own wellbeing Coaching: Health coaches provide regular patient check-ins to gather PROMs, support patients, and drive adherence.
Data Analysis: The Able Care team provides regular analysis of patient data, and flags patients at risk of functional decline to their care teams, providing in-depth reporting that allows for precision care.
