Cardiovascular disease (CVD) is a leading cause of mortality and high healthcare costs for Medicare Advantage (MA) beneficiaries. Additionally, MA plans receive financial incentives to improve key quality metrics related to CVD, including the Controlling Blood Pressure (CBP) measure. Digital interventions hold promise for supporting patients in the self management of chronic health conditions like CVD. In this study, we evaluated clinical outcomes among a cohort of MA beneficiaries over their first three months enrolled in Hello Heart, a mobile health cardiovascular risk self management program. We analyzed real world data from MA plan beneficiaries who enrolled in Hello Heart due to diagnosis of hypertension that was uncontrolled or for which they were unengaged, or heart failure. Members were included in the analysis if they had at least three months of continuous enrollment in the program and two or more blood pressure (BP) recordings. Outcomes included (1) systolic BP reduction, and (2) % of hypertensive users with a final BP below the CBP cutpoint (140/90 mmHg, mean systolic BP decreased by 14.5 mmHg (p 120 mmHg completed 18.4 ± 20.4 in app engagements. Greater app engagement predicted larger BP reductions (β = -0.08, t = -2.74, p = 0.006). A three month, app based CVD self management program for MA beneficiaries produced clinically meaningful results, including: (i) strong enrollment of a racially diverse population, (ii) clinically significant BP reductions with a sizable proportion achieving BP below the CBP measure threshold, and (ii) high rates of utilization, with greater engagement correlated with larger BP reduction. Together, these findings support digital self management as a scalable strategy for MA plans to improve blood pressure performance metrics.
Gurumoorthy et al. (Mon,) studied this question.