Our Solution is Based on Research
In 2011, Reese et al. published their findings on the risk of re-hospitalization after an Acute Myocardial Infarction (AMI) based on level of depression at the time of the AMI.
The findings were compelling: over the next three years, patients who were depressed at time of the AMI were re-hospitalized at almost twice the rate of patients with no depression.
At AbleTo, we wanted to follow up this research with a more specific question: if we engaged patients at the right time, with the right behavior change treatment and reduce patients’ depression, stress and anxiety, what would be the direct impact on medical health outcomes and cost of care?
The Cardiac Study
Aetna and AbleTo conducted a peer-reviewed research study, published by The American Journal of Managed Care. The study compared patients with a heart condition who completed an AbleTo behavioral treatment, for co-morbid behavioral health issues, to a similar group that did not complete the treatment.
1. The Participants
Participants were cardiac patients referred to AbleTo by Aetna. All participants went through an initial consult in which detailed, baseline data was gathered. The treatment group completed AbleTo’s behavior change treatment while the control group did not. Differences in baseline data between the two groups, across demographics, medical health, and behavioral health, were not statistically significant.
SAMPLE COMPARATIVE FACTORS
Demographics: 1 Age 2 Gender 3 Community Type-Rural
Medical Health: 1 Diabetes 2 Hypertension 3 Obesity
Behavioral Health: 1 Depression 2 Anxiety 3 Stress
2. The Behavior Change Treatment
The treatment group went through AbleTo’s behavior change treatment, which included 16 total sessions. After the initial intake consultation, the treatment group had one-on-one sessions with both a behavior change therapist (an LCSW) and a behavior change coach each week, for eight weeks.
3. The Results
Patients in the treatment group, but not the control group, experienced significant reductions in depression, anxiety and stress. Accounting for other possible, contributing factors, we found that the reduction in behavioral health issues directly resulted in fewer days in the hospital and a lower cost of care.
Reductions in Hospitalizations
These data were measured during the six months following AbleTo’s behavior change treatment.
Reductions in Depression
At the end of AbleTo’s behavior change intervention, the treatment group’s depression, anxiety and stress were significantly lower than at the start. In fact, at the end of treatment, the average behavioral health measurements were in the normal range.
DASS-21 Scores: Normal Ranges
Depression < 9 • Anxiety < 7 • Stress < 14
For the cost model, we tracked hospitalizations for the control group and calculated average direct cost-per-day of hospitalization for those patients. The data are reported here as annualized numbers.
We statistically accounted for factors that might skew the results. The conclusion is clear: treating behavioral health reduced the treatment group’s average cost-of-care over a 6-month period.
This controlled research was carried out on a cardiac population. We regularly collect and analyze data on patient populations we treat to ensure high-quality and effectiveness.