New York, NY - Building on the success of its “House Calls” program that has helped over 600 severely diabetic members control their conditions, MetroPlus Health Plan in conjunction with the New York City Health and Hospitals Corporation (HHC) has launched a similar Telehealth program for members with heart failure.

Members in the program which began January 2010, receive a blood pressure monitor and a bathroom scale, both electronically linked to a modem that transmits the member’s readings to their House Calls-Telehealth nurse.  Nurses speak with patients weekly but, anytime the patients’ readings fall outside established parameters, the nurse immediately contacts the member and if necessary, the member’s doctor is contacted to discuss possible changes in treatments and schedule a follow up doctor’s appointment.

“Before starting this program, I was in the hospital almost every six weeks and hated it every time,” says Brooklyn resident Joseph Currie. “Now, with my nurse’s help, I’ve learned to eat less and stay away from salt and sugar. Every other day I walk six miles.”

Currie, who used to be perpetually exhausted, now hopes his doctor will allow him to walk on a treadmill so he can keep up with his exercise when the weather won’t cooperate. “This program has made a big difference in my life,” he says.

In addition to improving quality of life, the program has significant financial implications for hospitals and health insurers. MetroPlus pays approximately $6,300 for a typical hospital stay of 5.8 days for a Medicaid patient like Currie (and $11,100 for a typical Medicare 3.7 day stay.) In recognition of the success of Telehealth programs, New York State now requires that such programs be part of the benefit package for Medicaid and Family Health Plus members.  

To date, thirteen members are enrolled in the MetroPlus Heart Failure Telehealth program that focuses on effective Care Management by nurses to reduce preventable Emergency Room visits and re-hospitalizations.  In addition, the electronic linkage provides members with their own website and permits participants to access information about their medications including dosage and frequency. The program continues to expand as new HHC facilities come on board. According to the National Heart Lung and Blood Institute, 4.8 million Americans have congestive heart failure (CHF) with 400,000 new cases reported annually. The CDC points out that approximately 260,000 people die from CHF each year.

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MetroPlus Health Plan, Inc, a wholly-owned subsidiary of the New York City Health and Hospitals Corporation (HHC) is a prepaid health services plan that offers low or no-cost health insurance to eligible people living in Manhattan, Brooklyn, Queens and the Bronx through the following plans: Medicaid Managed Care, Child Health Plus, Family Health Plus and a Medicaid HIV Special Needs Plan (SNP), Partnership in Care. Partnership in Care is the largest HIV SNP in the United States. Effective January 1, 2010, MetroPlus began offering MetroPlus Platinum Plan (HMO), a zero premium plan, for anyone eligible for Medicare living in the Plan’s service area. MetroPlus also offers MetroPlus Advantage Plan (HMO), for those who are eligible for Medicare and receive full or partial Medicaid benefits, MetroPlus Select Plan (HMO), for those eligible for Medicare and for full Medicaid benefits, and MetroPlus Medicare Partnership in Care Plan (HMO), for people with HIV/AIDS eligible for Medicare with or without Medicaid. MetroPlus offers MetroPlus Gold, a plan for New York City Health and Hospitals Corporation (HHC) employees and their dependents.

MetroPlus was rated the number one Medicaid Managed Care health plan in New York City for 2009 based on indicators chosen by the New York State Department of Health (NYSDOH) and published in the Consumer’s Guide to Medicaid Managed Care in New York City.

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