Patient Outcomes

It’s clear: Digital disease management solutions improve outcomes & increase revenues

Patients with multiple chronic conditions (MCC) account for 64% of all clinical visits and use 86% of all healthcare resources.1 And for good reason ‒ patients with MCC face a heightened risk of major health events that could lead to death.

Despite this, the average MCC patient spends only a few hours a year at their doctor’s office.2 This gap in care leads to neglected treatment plans and weak support structures for those hoping to build healthy habits. Indeed, one third of all prescriptions are never filled, and over half of all medications are administered incorrectly.3

According to a recent Kaiser study, the most common factors that lead to patient noncompliance are forgetfulness, questions about medication, denial of health issues, and ambivalence.4 With these challenges in mind, has created a health management platform that bridges care gaps, improves patient outcomes, and boosts physician revenues.

Healthier Patients

In 2017, (then known as Salusive Health) was awarded an Innovation Grant by a large Bay Area Health System, enabling a 60-day IRB-approved study. We worked with a family care physician in Roseville, CA to compare patients using the platform with control groups (CG 1 & CG 2) assigned the practice’s routine treatment plan, with 30- and 60-day reporting follow-ups. CG2 was also instructed to maintain a daily journal of their BP to be reviewed at follow-up appointments.

Results were promising. Using the program, patients with uncontrolled hypertension (>140/90) were at least 33% more likely to achieve desirable Blood Pressure (BP) ranges compared to control groups (CG), and were 61% more engaged in their treatment.

CG1 and CG2 had response rates of just 33% and 44%, respectively. Of the patients who responded in both CGs, only 50% managed to keep their BP in a healthy range.

Such low response rates and poor condition management illustrate the dilemma long faced by healthcare professionals: Once a patient leaves the clinic, monitoring becomes challenging, and most patients become non-compliant.

In contrast, patients using had a 100% response rate, measuring BP an average of 1.4 times per day. As a result, patients were at least 33% more likely to successfully manage their uncontrolled hypertension. Additionally, in monitoring these patients, we discovered that up to 36% of patients failed to respond positively to their medication regimen, an insight that allowed care providers to adjust treatment plans in real-time.

At-home health monitoring

Vitals monitoring devices collect health, compliance, and symptom data, allowing care teams to adjust patient treatment plans between clinic visits.

Personal support

Wellness coaches interface with our members one-on-one to manage health between visits, build trust and help care teams form a fuller picture of each patient’s unique health challenges and social determinants of health.

Administrative assistance

We handle all coding and insurance reimbursement, freeing up clinics and health systems to focus limited resources.

AI-powered care management

An AI nursing “coach” draws on historical patient outcomes and interventions to give care teams the insights they need to respond to patient needs efficiently and effectively.

Return on Investment

In addition to fueling improvements in patient compliance and outcomes, gives clinics an opportunity to add extra revenue streams to their business.

By partnering with, clinics can take advantage of new Medicare programs focused on chronic condition management (like CPT 99490) that completely cover any associated costs, while also creating an incremental revenue stream. For example, a physician who implements the program with a patient panel size of 335 patients can claim annual reimbursements of over $92,460 annually.

There are no upfront costs to deploy the program with optional EMR integration, which means clinics can see the clinical and financial benefits of using in the first month of billing.

Time Saved

Referring routine care of chronic conditions to helps clinics focus on their patients most in need, freeing up clinic capacity and resources. Based on the patient panel above, could save a physician up to 306 hours per month of routine follow-up.

  1. Multiple Chronic Conditions Chartbook. A 2010 Medical Expenditure Panel Survey Data. AHRQ. April 2014 Pub No 14-0038. Pg 7.
  2. “Automated Hovering in healthcare—watching over the 5000 hours.” Asch DA, Muller RW, Volpp KG. N Engl J Med. 2012 Jul 5; 367(1) 1-3
  3. “Patient Nonadherence: Tools for combating Persistence and Compliance Issues.” Frost and Sullivan Whitepaper. Pg 3.
  4. The B-SMART appropriate medication-use process: a guide for clinicians to help patients — part 1: barriers, solutions, and motivation. E Oyekan et al. Permanente J. 2009;13:62-69.

Empower your team to transform patients’ lives