Approximately 6.5 million adult Americans are living with heart failure (HF). There are more than one million HF hospitalizations each year, and it is one of the most common causes of hospitalization, readmission, and death. Only 10% of all FFS Medicare beneficiaries have HF, yet their costs are 33% of all Medicare costs. The economic impact associated with HF will exceed $70 billion in 2030.
Learn how AI can help to promote early diagnosis of HF, reduce HF readmissions, and address avoidable adverse events. Discover how AI can help to identify patients at high risk of HF, predict preventable hospitalization due to HF, and identify complications tied to modifiable risk factors (e.g., poor medication adherence).
Data extracted from health insurance medical claims with details about dates and place of service, diagnosis codes, key procedures, use of medical equipment, and provider specialties.
Data extracted from health insurance pharmacy claims with details about each medication and its type, fill dates, days supply, pharmacy location, and prescribing clinician.
EHR data with comprehensive patient histories of vital signs and symptoms, problem lists and chief complaints, tests results, diagnoses and procedures, and prescriptions.
ClosedLoop generates explainable predictions using
thousands of auto-generated, clinically relevant contributing factors
Today, approximately 6.5 million adult Americans are living with heart failure (HF).¹ By 2030, this is estimated to rise to 8 million people with total economic costs reaching $70 billion at which point 2.97% of U.S. adults will have HF and 71% of them will be age 65 or older.² With more than one million hospitalizations each year, HF is one of the most common causes of admissions and readmissions and a leading cause of mortality; after a diagnosis of HF, survival estimates are 50% and 10% at five and ten years, respectively.³
Beneficiaries with HF constitute 10.5% of all FFS Medicare beneficiaries and their costs (excluding medications) make up 33.2% of all Medicare costs.⁴ HF is a chronic disease characterized by acute exacerbation, and a major cost driver is treatment for worsening HF and fluid overload, 80% of which occurs in inpatient settings.²𝄒³
Many instances of hospitalization for HF patients are considered preventable, yet HF remains the leading cause of hospitalization for patients over age 65.²𝄒⁵ HF admissions also generate the highest number and highest rate of 30-day readmissions among Medicare beneficiaries.⁶𝄒⁷
Organizations can employ predictive analytics to identify high risk HF patients and use insights from AI to enroll patients in care management programs. Proactively identifying high-risk HF patients and intervening to prevent significant exacerbations that cause hospitalization is essential to improving quality of life and reducing avoidable costs. For example, interventions centered on patient self-management have been shown to reduce the odds of readmission after one year by 40%.⁸ Such programs prevent hospitalizations by strengthening care continuity, improving adherence to complex medication regimens, and ultimately identifying early warning signs more readily.
1. Benjamin, Emelia J., et al. “Heart Disease and Stroke Statistics—2019 Update: A Report From the American Heart Association.” Circulation, vol. 139, no.10, Jan. 2019, https://www.ahajournals.org/doi/10.1161/CIR.0000000000000659
2. Fitch K, Lau J, Engel T, Medicis JJ, Mohr JF, Weintraub WS. The cost impact to Medicare of shifting treatment of worsening heart failure from inpatient to outpatient management settings. ClinicoEconomics and Outcomes Research. 2018;Volume 10:855-863. doi:10.2147/ceor.s184048
3. Roger VL. Epidemiology of Heart Failure. Circulation Research. 2013;113(6):646-659. doi:10.1161/circresaha.113.300268
4. Fitch K, Engel T, Lau J. The Cost Burden of Worsening Heart Failure in the Medicare Fee for Service Population: An Actuarial Analysis. Milliman, Inc; 2017.
5. Michalsen A, König G, Thimme W. “Preventable causative factors leading to hospital admission with decompensated heart failure.” BJM Journals, Heart, vol. 80, no. 5, Nov. 1998, pp. 437–441.
6. Jencks, Steven F., et al. “Rehospitalizations among patients in the Medicare fee-for-service program.” The New England Journal of Medicine, vol. 360, no. 14, Apr. 2009, pp. 418–1428. DOI:10.1056/NEJMsa0803563
7. Reddy, Yogesh, et al. “Readmissions in Heart Failure: It’s More Than Just the Medicine.” Mayo Clinic Proceedings, vol. 94, no. 10, Oct. 2019, pp. 1919–1921. DOI: https://doi.org/10.1016/j.mayocp.2019.08.015
8. Jovicic, A., et al. “Effects of Self-Management Intervention on Health Outcomes of Patients with Heart Failure: A Systematic Review of Randomized Controlled Trials.” BMC Cardiovasc Disorders, vol. 6, no. 43, 2 Nov. 2006, https://doi.org/10.1186/1471-2261-6-43.