2023 Outcomes Report

Reversing the tide of chronic disease in America

How Cadence’s remote monitoring solution offers a path forward

The Problem

With 6 in 10 adults living with one or more chronic conditions, chronic disease is today’s leading cause of death and disability in the U.S. Several weeks after Cathy Burnet underwent a routine gallbladder procedure in the summer of 2019, she began experiencing a sharp pain in her stomach followed by chest pain. Cathy, a 70-year-old woman living in Lacey, Washington, went to see her doctor for a round of blood tests and an EKG and promptly learned that she was in the midst of a massive heart attack.

She rushed to the emergency room and received lifesaving care, but Cathy was later diagnosed with hypertension. Cathy’s doctor emphasized the importance of controlling her blood pressure, but she had difficulty doing so and began experiencing periodic dizziness, heart palpitations, and chest pains. This was her new normal – attempting to manage her hypertension from home, Cathy constantly worried about her health and feared another heart attack was on the horizon. Because she lives alone, Cathy had nobody to turn to for support.

Last year, Cathy’s primary care provider ordered Cadence for her to bring her peace of mind and help manage her hypertension from home. Cathy now wakes up and takes her weight and blood pressure each morning, which transmit automatically via cell towers to her medical team. Whenever she experiences symptoms, she no longer has to guess whether they require medical attention; Cadence clinicians monitor her vitals daily, check-in with her as needed, and titrate her medications in consultation with her provider. After one year on the Cadence program, Cathy’s weight and blood pressure are now in target ranges.

65% OF MEDICARE BENEFICIARIES collectively suffer from hypertension, congestive heart failure, and/or type 2 diabetes

There are millions of Medicare-age Americans living with a chronic health condition who are not getting the care they need today. With 6 in 10 adults, or 133 million Americans, living with one or more chronic conditions, chronic disease is today’s leading cause of death and disability in the U.S. and the leading driver of the nation’s $4.1 trillion in annual health care costs. For seniors, that figure is more pronounced, with a staggering 65% of Medicare beneficiaries suffering from hypertension, congestive heart failure, and/or type 2 diabetes.

The unfortunate reality is that patients who are managing chronic conditions require far more touchpoints and care than our primary care physicians have time to deliver. The result is countless health emergencies and costly ambulance and ER visits that could have been prevented.

75% OF ALL HEALTHCARE SPEND in the U.S. on chronic conditions

ONLY 1.5% OF HEART FAILURE PATIENTS achieve guideline-directed medical therapy (GDMT) after hospitalization

The Cadence Solution

Our mission is to deliver life-changing treatment to 1 million people living with chronic conditions by the end of the decade.

Cadence partners with the leading academic medical centers and health systems in the U.S. Together with our health system partners, we’ve built a virtual heart failure clinic, virtual diabetes clinic, and virtual hypertension clinic that deliver guideline-directed care to patients 24/7 and produce world-class outcomes.

Today, we care for over 13,000 patients in 18 states, collect more than 450,000 vitals per month, and have conducted over 97,000 remote visits with patients to date.

Patient Impact

The data show our approach is resulting in improved clinical outcomes.

Hypertension

In a study of 4,006 hypertension patients enrolled in Cadence from February 2022 to April 2023 in 11 states across the U.S., we saw a ~2x increase in the number of patients at goal blood pressure (BP<130/80) at follow-up, compared to baseline (31% vs. 15%; p<0.001).

Heart Failure

In a study of 367 patients with heart failure with reduced ejection fraction (HFrEF) who were enrolled in Cadence from August 2021 to April 2023, the percentage of patients on more than 50% dose of all four pillars of GDMT significantly increased. Additionally, there was a 3.2x increase in the percentage of patients on all four pillars of GDMT at follow-up.

Diabetes

Using Cadence’s program, 43% of type 2 diabetes patients achieved their blood glucose goal.

The data show that Cadence has helped prevent health issues before they escalate. We have seen an 18% reduction in the number of emergency department visits for patients after 6 months of participation in the Cadence program, compared to those who have not enrolled.

Patients enrolled in Cadence are highly engaged and become more actively invested in improving their health over time. For example, 84% of enrolled patients engage with Cadence’s program by taking their vitals 16+ days per month. Additionally, 80% of patients remain actively engaged after 6 months of participating in the program.

Lower Cost of Care

Our remote monitoring solution significantly reduced the total cost of care for chronic disease patients. In a study of patients and eligible patients with heart failure, hypertension, and type 2 diabetes, the data show that Cadence’s solution resulted in a 51% decrease in patients’ total cost of care, inclusive of the incremental costs associated with RPM services. In a study for hypertension patients, there was a 50% reduction in the total cost of care.

Cadence’s solution reduces care costs across the board. For example, there has been a 63% reduction in the number of ambulance rides for patients enrolled in the Cadence program.

Clinician Impact

Cadence’s solution helps physicians deliver better clinical care while saving them time. Patients with chronic disease place particular stress on primary care physicians, including a high volume of calls and EMR messages, given the high-touch interactions that these conditions require.

Cadence’s team of nurse practitioners, registered nurses, and clinical navigators act as an extension of physician practices. Using national guidelines and mutually agreed upon clinical protocols, the Cadence team titrates medications, orders labs, and provides education and lifestyle coaching to patients. Patients have access to Cadence’s team 24/7, thereby increasing access without burdening primary care physicians.

Over 95% of Cadence patients had an order placed for RPM by their primary care physician.

Additionally, there was a 7% reduction in the number of no-shows to partner clinics for Cadence patients. Participating providers are highly satisfied with Cadence’s program, giving Cadence a 77 net promoter score in satisfaction surveys.

Outlook

We must collaborate to solve the accelerating chronic disease crisis in the U.S., and our data show that Cadence can play an important role at scale. It has been more than one year since Cathy Burnet enrolled in Cadence, and according to Cathy, things are going much better with her health: “I’m so happy my doctor recommended Cadence to me,” she shared.

Providers, patients, and policymakers must collaborate to solve the chronic disease crisis in the U.S., and the data show that Cadence can play an important role at scale. Together, we look forward to much needed transformation on how chronic disease is managed over the next decade.