Reviewing a facility’s unplanned hospitalizations is more than just statistics—it shows a direct cost for missed opportunities. Recent clinical evidence indicates that these costs can be recaptured with technology proven to achieve 89% detection accuracy for respiratory and cardiac deteriorations, as well as 77% accuracy for all health deterioration events.
The results possible with this high level of detection are a stark economic contrast to the costs your facility or community faces when critical changes in a patient’s condition go unnoticed.
The True Cost of What’s Missed
Missed deteriorations don’t simply disappear—they compound into more serious, expensive, and dangerous situations. For ACOs and ISNPs managing attributed populations under value-based contracts, these missed opportunities directly impact financial performance and quality ratings.
Financial impact of missed deterioration:
- Average cost per unplanned hospital admission: $15,000-$25,000.
- CMS readmission penalties can reach 3% of Medicare reimbursements.
- Each preventable hospitalization directly increases MLR by $15,000-$25,000 per member.
- Unplanned admissions reduce ACO shared savings potential and can trigger penalty payments.
- Liability exposure increases with delayed recognition of deterioration.
- Emergency transfers require immediate high-cost resources and staffing.
Clinical consequences:
- Later detection often means more invasive interventions.
- Extended hospital stays due to advanced deterioration.
- Increased mortality risk with delayed treatment initiation.
- Impacts HEDIS scores, Star ratings, and ACO quality benchmarks.
- Greater patient distress and potential litigation exposure.
Detection Paradigm Shift
To understand why 89% and 77% detection accuracy is revolutionary, consider the current baseline in most nursing facilities. Traditional vital sign monitoring—generally done every 4-8 hours—creates surveillance gaps where deterioration can progress undetected for extended periods. For ACOs managing thousands of attributed members across multiple care settings, these gaps represent significant population health risks.
Current detection limitations:
- Manual vital signs capture only snapshots, not trends.
- Night shift coverage often has reduced monitoring frequency.
- Subtle changes in respiratory patterns frequently go unnoticed.
- Early signs of sepsis, pneumonia, and cardiac events can be missed.
- ACOs lack visibility into member deterioration across attributed populations.
The detection rates achieved through continuous touchless monitoring represent a fundamental improvement over intermittent manual checking, particularly for the types of gradual deterioration that characterize many serious health events affecting patient populations.
Economics of Early vs. Late Detection
Case study analysis from the clinical data:
Early detection scenario:
- Alert issued 4.99 days before hospitalization.
- Clinical team initiates targeted antibiotic therapy for developing pneumonia.
- Patient condition stabilizes with oral medications and increased monitoring.
- Cost: Standard care plus additional clinical assessment.
- Prevented $20,000 increase in total medical spend per member.
- Avoided readmission penalty, maintained quality scores.
- Outcome: Successful treat-in-place care, no hospital transfer required.
Missed detection scenario:
- Patient deterioration progresses undetected.
- Crisis-level symptoms trigger emergency transfer.
- Hospitalization required for IV antibiotics and intensive monitoring.
- Cost: Emergency transport + hospital admission + potential readmission.
- $20,000+ adverse impact on shared savings calculation.
- Direct hit to medical loss ratio performance.
- Outcome: Extended recovery, increased risk for complications.
The economic difference between these scenarios can exceed $20,000 per event, not including the operational disruption and patient impact of emergencies. For ACOs with thousands of attributed members, preventing even a small percentage of these events creates substantial opportunities for shared savings.
Risk Management Implications
These high-accuracy detection rates provide a quantifiable improvement in clinical surveillance that directly addresses liability concerns and supports ACO quality performance:
Reduced exposure areas:
- Earlier recognition of deterioration supports defensible clinical decisions.
- Documented continuous monitoring demonstrates proactive care standards.
- Reduced emergency situations decrease high-risk transfer complications.
- Earlier intervention often prevents progression to life-threatening conditions.
- Enhanced documentation supports accurate quality measure reporting.
Enhanced standard of care:
- 24/7 monitoring exceeds traditional surveillance standards.
- Objective vital sign data supplements clinical judgment.
- Trend analysis capabilities identify subtle changes that human observation might miss.
- Enables systematic monitoring across attributed populations.
Compound Value of Incremental Improvement
While these detection rates aren’t perfect, in healthcare, incremental improvements compound rapidly. For ACOs and ISNPs managing large, attributed populations, the math becomes compelling:
Skilled nursing facility impact calculation example:
- Typical 200-bed facility: 40-50 unplanned hospitalizations per year.
- With 77% detection: 30-38 potential interventions before crisis point.
- Prevented hospitalizations (assuming 50% intervention success): 15-19 events
- Cost savings: $225,000-$475,000 annually
- Reduced CMS penalty exposure.
- Improved patient satisfaction scores.
- Enhanced facility reputation.
Population-level impact calculation example:
- Typical ACO: 10,000 attributed members across multiple care settings.
- Traditional hospitalization rate: 26 per 100 members annually
- With 77% detection: 2,056 potential early interventions per year
- Prevented hospitalizations (assuming 50% intervention success): 614 events
- Shared savings: $1.5-3.75 million in prevented medical spend
- MLR Improvement
- Quality metrics improve for readmission rates and HEDIS scores.
- Enhanced ACO/ISNP Star ratings and quality bonus eligibility.
The Technology Behind the Numbers
The 89% and 77% detection rates were achieved through continuous respiratory and heart rate monitoring that identifies deviations from each patient’s baseline. This approach recognizes that health deterioration manifests differently across patients and conditions—a critical capability for personalized care and managing diverse ACO populations.
Key Detection Capabilities:
- Respiratory rate changes often precede other vital sign abnormalities.
- Heart rate variability can indicate developing sepsis or cardiac events.
- Trend analysis identifies gradual changes that might be missed in spot checks.
- Baseline comparison accounts for individual patient variations.
- Aggregate data supports ACO quality reporting and population health insights.
Strategic Planning Considerations
For facility administrators, ACO executives, and population health directors evaluating monitoring technology investments, the 77% detection rate provides a concrete benchmark for ROI calculations across all hospitalizations:
Implementation Factors:
- Technology cost vs. prevented hospitalization savings and shared savings impact
- Staff training requirements for alert response protocols
- Integration with existing clinical workflows and ACO care management systems
- Scalability across different patient acuity levels and care settings
- Ability to monitor members across multiple facilities
Performance Monitoring:
- Tracking detection rates for your specific attributed population.
- Measuring intervention success rates when alerts are generated.
- Documenting cost savings from prevented hospitalizations and MLR improvement.
- Assessing improvement in HEDIS scores, readmission rates, and Star ratings.
- Quantifying contribution to ACO financial performance.
Beyond the Numbers: Patient and Population Health Impact
While financial metrics drive business decisions, the human impact of improved detection rates provides additional justification for investment in continuous monitoring technology:
- Reduced trauma for patients experiencing emergency hospitalizations
- Decreased family anxiety when deterioration is caught early
- Improved end-of-life care through earlier recognition of terminal changes
- Enhanced patient satisfaction and quality of life outcomes
- Demonstrates ACO commitment to proactive population health management
The Path Forward
The demonstrated results of early detection and intervention establish a new benchmark for what’s possible in patient monitoring and population health management.
For healthcare, ACO, and ISNP leaders, this data provides the evidence needed to justify technology investments that can transform both clinical outcomes and financial performance.
Next steps for implementation:
- Assess current detection capabilities: Audit your current surveillance gaps.
- Calculate potential impact: Apply the 77% detection rate to your hospitalization data and shared savings calculations.
- Evaluate technology options: Review continuous monitoring solutions that can achieve similar results.
- Develop population health strategy: Plan for staff training, workflow integration, care management, and quality reporting systems.
The Evidence Presents a Clear Case
The data presented here reveals a fundamental truth: the difference between early detection and crisis response determines both patient outcomes and organizational financial performance. Healthcare organizations relying on traditional vital sign monitoring are accepting unnecessary clinical and financial risk.
The question facing healthcare leaders isn’t whether this ambient technology works—the data proves it does. The question is whether your organization will be among the early adopters who gain a competitive advantage through superior population health management or continue accepting the compounding costs of missed deteriorations. For ACOs and ISNPs committed to value-based care success, the path forward is clear: evaluate your current capabilities, calculate the potential impact, and implement monitoring solutions that deliver proven results.
Want to see how these detection rates translate to your ACO or ISNP’s specific attributed population and shared savings potential?
Download the full clinical report for detailed methodology, statistical analysis, and findings.
The clinical study “Neteera System Efficacy Study in Predicting Hospitalizations or Adverse Events” was conducted from November 2024 to February 2025 across five nursing facilities in partnership with TapestryHealth. All patient data were handled in compliance with privacy regulations under appropriate data use agreements. The study findings are based on retrospective data and subject to limitations; results may vary depending on clinical context and implementation. Neteera disclaims all warranties, express or implied, including any implied warranties of merchantability or fitness for a particular purpose. Use of the Neteera System must comply with all applicable regulatory, clinical, and safety guidelines.