Care coordination solution lowers cost of managing Crohn's disease, study finds

When people with Crohn’s disease worked together with their gastroenterologists to detect and address worsening symptoms sooner using a digital care coordination solution, they were more likely to stay out of the hospital, a new study has found.

This reduced the annual medical cost for each person by $6,500, according to research from Blue Cross and Blue Shield of Illinois and SonarMD, a population health company that provides clinical decision support and patient engagement tools to help payers improve the health of patients with complex, chronic conditions.

“Those savings come from avoided hospitalizations and outpatient visits,” Lawrence Kosinski, M.D., a practicing gastroenterologist and SonarMD’s founder and chief medical officer, said in a statement.

The research was presented at a digestive disease medical conference in San Diego on Sunday.

As part of a collaboration between the two companies, researchers compared a group of 176 Crohn’s disease patients who were enrolled in SonarMD’s solution to a matched control group during a two-year period. 

This study proves that SonarMD’s care coordination solution can lead to significant cost savings for patient populations with high-beta conditions such as Crohn’s disease, Kosinski said. High-beta conditions are symptomatic, chronic and likely to deteriorate rapidly—leading to complications, hospitalizations and highly variable per capita costs. These conditions are often treated with high-cost therapeutics, such as specialty drugs.

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BlueCross BlueShield Venture Partners is an investor in SonarMD, which raised $10 million in funding

“The results of this research study demonstrate how an innovative approach to patient engagement and monitoring can improve access to care, health outcomes, and affordability,” Derek Robinson, M.D., vice president and CMO at Blue Cross and Blue Shield of Illinois, said in a statement. 

SonarMD evolved from a project Kosinski embarked on with Illinois Gastroenterology Group and Blue Cross Blue Shield of Illinois to reduce costs associated with complications from inflammatory bowel diseases such as Crohn’s. While analyzing claims on thousands of patients with inflammatory bowel diseases, Kosinski found less than a third of the patients admitted to the hospital for a Crohn’s complication had been seen by a gastroenterologist within 30 days before admission.

Project Sonar was developed, a system that automatically “pings” participating Crohn’s patients on a monthly basis with five structured questions. Patients’ responses were used to calculate a numerical score that, over time, helped clinicians track the severity of the condition and intervene if the clinician considered it appropriate.

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That system has been carried over to SonarMD. The solution regularly pings patients with clinical questions they can respond to via text, email or phone call. Using those responses, SonarMD calculates what's called a sonar score that correlates with symptom intensity. The company then tracks the score over time to determine which patients are at risk of deteriorating and then works with the patient’s care team to intervene when necessary.

SonarMD contracts with payers to work directly with sub-specialists in their network to provide value-based care for patients with high-beta conditions.

“As a Crohn’s patient, I don’t always recognize when my body is trying to tell me something because I think my symptoms are just par for the course,” Tami Speten, a patient who uses SonarMD, said in a statement. “I was once called into my gastroenterologist’s office because of my sonar score. We quickly learned my blood and iron counts were dangerously low. I had no idea I was so sick."

Speten said use of the technology solution helped her gastroenterologist identify a problem early, take action and prevent her from ending up in the hospital. "This technology really helps to guide me through my illness and has strengthened my relationship with my doctor," Speten said.