Adviser Fall 2018 Vol 1 - Page 24

VillageCare’s Rango: Digital Tools to Promote Medication Adherence and Patient Engagement Age 23 VILLAGECARE, a New York City community-based, not-for-profit organization that serves individuals with post-acute and chronic care needs, received a Centers for Medicare and Medicaid Services (CMS) Health Care Innovation Award to develop Rango, a mobile application and website that was found to be effective in empowering individuals living with HIV to better manage their condition. Program enrollment began in 2015, with the pilot demonstration expiring in December 2017. Overview of Platform The Rango program addressed many challenges that HIV/AIDS patients, providers, policymakers and other stakeholders face by increasing patient activation, improving medication compliance and reducing total cost of care for HIV positive individuals. Rango Services include: • Medication and appointment reminders; • Virtual support groups facilitated by professionals; • Engaging online community; • Moderated discussion boards on a variety of health and healthy living topics; • Live chat and virtual Q&As with Health Coaches; • Private messaging inbox; • Text message and app notification broadcasts; • Matching to a trained Peer Mentor; • Article library with easy-to-understand explanations about HIV/AIDS, common comorbidities, medications and other information; • RMDY digital therapeutics platform (personal health and wellness tracking with guided interventions); and • Healthify social services database. All Medicare and/or Medicaid beneficiaries residing in New York City who have been prescribed medications for HIV/AIDS were eligible to participate in the program. Rango services could be accessed from any computer or smartphone, with many features made available via a standard cellular device. These features are designed to be member-friendly and easily accessible. The Rango platform is HIPAA-compliant, and all data transmissions are encrypted. User Demographics There were approximately 4,400 members enrolled in Rango. Of these enrollees, approximately 59 percent were male. The age distribution of enrollees was: Age Percentage of Enrollees 18-30 years 31-45 years 46-55 years 56-64 years 65+ years 6% 23% 41% 25% 5% 18-30 years 31-45 years 46-55 years 56-64 Activity years User 65+ years Percentage of Enrollees 6% 23% 41% 25% 5% Medication reminders were the most utilized feature for both the app and web browser User Activity Medication reminders were the most utilized feature for both the ap platforms. Utilization information for the most platforms. Utilization information for the most popular app and web popular app and web browser features among enrollees is provided below: enrollees is provided below: App Feature Medication Reminders Q&A Messaging Library Article Post in the Forum Web Browser Feature Medication Reminders Post in the Forum Library Article Q&A Messaging Percentage of Enrollees Utilizing 52% 38% 25% 20% Percentage of Enrollees Utilizing 46% 37% 33% 26% Health Care Expenditures Health Care Expenditures A 2017 research research report conducted the New A 2017 report conducted by the by New York University (NYU) Analytics Lab (HEAL) (NYU) evaluated the experience of Rango participants York University Health Evaluation & health expenditures data for HIV positive Analytics Lab (HEAL) evaluated the Medicaid-enrolled experience individu Rango in 2015 to HIV positive Medicaid-enrolled individuals not usin of Rango participants and compared six-month health expenditures data for HIV positive Overall health care service expenditures increased for the Rango par the comparison group, individuals which experienced decreases using in expenditure Medicaid-enrolled who started in overall monthly expenditures for the Rango participant group. Ho Rango in 2015 to HIV positive Medicaid-enrolled specific health care service expenditures indicated a relative reducti individuals not and using the platform. (decrease of 8%) a relative increase in visits to a primary care ph Rango participants. Furthermore, there was a 6% increase in the rat Overall health care service expenditures participants filled prescriptions for any of six selected HIV drug medi increased for the Rango participant group the benefits of me they began using Rango, which may demonstrate text messages from the program. group, which relative to the comparison experienced decreases in expenditures, with a $251 increase (5 percent) in overall monthly expenditures for the Rango participant group. However, a closer look at specific health care service expenditures indicated a relative reduction in hospitalizations (decrease of 8 percent) and a relative increase in visits to a primary care physician (increase of 3 percent) for Rango participants. Furthermore, there was a 6 percent increase in the rate at which Rango participants filled prescriptions for any of six selected HIV drug medications compared to when they began using Rango, which may demonstrate the benefits of medication reminders and text messages from the program. HIV Outcomes Another research study conducted by VillageCare evaluated the impact of Rango on viral load (VL) suppression for HIV positive individuals enrolled in the program. The study found that 94 percent User Activity Adviser publication of for LeadingAge New | Fall 2018 Medication reminders were the a most utilized feature both the app and web York browser platforms. Utilization information for the most popular app and web browser features among