After-Hours Telemedicine Coverage Saved Skilled Nursing Facility $1.5M

Use of after-hours telemedicine in one New York skilled nursing facility reduced avoidable hospitalizations significantly, according to a case study published in the American Journal of Managed Care (AJMC).

The study was led by Dr. David Chess, the founder, president, and chief medical officer of Tapestry Telehealth, a company focused on SNFs in rural communities.

The SNF in the AJMC study, however, was the 365-bed Cobble Hill Health Center in Brooklyn, N.Y. The study, which took place from March of 2015 to March 2016, tracked and evaluated clinical and financial outcomes for the initial year in which the TripleCare technology was implemented. It found that of the 313 patients cared for by telemedicine-enabled covering physicians, 259 were treated on-site, including 91 avoided hospitalizations as verified by a review conducted by the facility’s medical director at the time, Dr. Himanshu Pandya. Pandya currently serves as medical director at Hillside Manor Nursing home in Queens, New York.


The director who made the retrospective review was not associated with TripleCare, the study said.

The study found that payers were the primary financial beneficiary of the telemedicine technology: The total Medicare savings based on the 91 patients with avoided hospitalizations was estimated at more than $1.55 million at the SNF during the year timeframe.

The facility in question paid $60,000 a year for the telemedicine service, a figure that includes the technology.


“This fee was offset by preventing hospitalizations; helping the facility maintain census, especially in its short-term rehabilitation unit; capturing lost Medicaid days while a patient was hospitalized; and a decrease in transportation costs,” the authors wrote. “The facility continues to support this clinical service.”

The authors said if the findings were extrapolated to the more than 1.7 million nursing facility beds in the U.S., Medicare could save more than $1.5 billion a year.

The study was supported by a grant from the Fan Fox and Leslie A. Samuels Foundation; the TRECS (Targeting Revolutionary Elder Care Solutions) Institute oversaw the study’s implementation and evaluation of the outcomes.

Written by Maggie Flynn

This article has been updated to include Pandya’s current position.

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