Abstract

Abstract BACKGROUND IBD constitutes a diverse and progressive spectrum of chronic illnesses, presenting formidable management challenges for both patients and healthcare providers. Due to the inherent unpredictability of disease progression, proactive monitoring strategies are crucial for optimal IBD management. The linchpin of proactive monitoring in IBD is patient engagement, which is necessary for continuous monitoring of disease activity. GI practices using SonarMD, a technology-driven care coordination company specializing in IBD, have consistently maintained an enrollment and engagement rate exceeding 80%. This study demonstrates the disparity in clinical outcomes between an engaged patient population utilizing SonarMD’s platform and an unengaged cohort within a single large gastrointestinal (GI) practice under a value-based agreement with a major health plan. METHODS The study cohort was composed of a population of 1173 patients attributed by the heallth plan on the basis of ICD-10 Codes who had a diagnosis of Crohn's Disease (K50) or ulcerative colitis (K51). 939 (80%) enrolled in the program and 234 (20%) remaining unenrolled. Demographic and clinical characteristics of the patient groups are detailed in Table 1. The enrolled and unenrolled groups exhibited similar metrics with regard to: age, gender, average risk score (AVG), disease type, stricturing/fistulizing disease, and history of behavioral health diagnoses. The enrolled group did demonstrate a 10% higher utilization of biologics. The SonarMD platform was only deployed into the enrolled group. Claims data (including pharma claims) from a single health plan, which insured all cohort patients, was the source for the utilization data analysis. The study period was the calendar year 2022 with a claim runoff period of 3 additional months. RESULTS The IBD specific Inpatient hospitalization rate and ED Visit rate for each group is shown in table 2. There is a 10X statistically significant difference in both hospital inpatient admission rate and ED visit rate between the engaged and unengaged populations. (p = 0.02). Two thirds of the INPT/ED admissions for the entire attributed population were driven by the unenrolled group. CONCLUSIONS This study highlights the influential role of proactive patient engagement in the management of IBD, exemplified by the utilization difference for inpatient care and ED usage and its potential to optimize clinical outcomes. Proactive patient engagement is critical in population management of symptomatic chronic disease. An unengaged population represents a significant risk for unnecessary morbidity and healthcare cost. Provider-payer-industry partnerships can help build the infrastructure necessary to accomplish high rates of engagement. You can’t manage the patient you don’t engage.

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