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Three Tips to Reduce Readmission Rates


IMG_0120.jpgBy Angela Muth, Executive Director of Healthcare Management at CoreSource

Hospitalization is a big deal for clients and members, both financially and emotionally. Through our in-house team of healthcare management professionals, we work to help reduce the need for hospital admissions and re-admissions among our client populations by educating members, empowering them, and assisting them in their personal health journeys.

We built our in-house, fully integrated program upon a foundation of true caring, beginning with our dedicated team of nurses—representing decades of experience and covering over 70 specialties and sub-specialties. We bring a spirit of caring service and join it with industry-leading data and analytics so we can better serve our clients and their populations. Through our decades of experience with patients, and the industry, we have found several effective steps to help improve outcomes for patients after hospitalization and reduce the financial burden of unnecessary re-admissions. In 2017, our case management and utilization management programs helped to increase savings to our clients by 183%—just under $3 million dollars per month—and delivered a combined ROI of 4:1.
 
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Three key factors contribute to improved outcomes for our members after hospitalization. Is the member:
  • Informed about their condition and treatment plan?

  • Receiving and taking their medications as prescribed?

  • Making it to their outpatient follow up appointments?

 
We help our members get to “YES” for those three questions.
 

Communication is Key

When we become aware that a member requires medical care or has been newly diagnosed, we conduct outreach. CoreSource nurses reach out to the member, to ensure that they understand the diagnosis and the treatment plan that their healthcare provider outlined for them and to answer any questions they have. We provide the member with information and address their concerns. We serve as one point of contact for members who maybe do not quite understand what the physician just told them during their office visit, or what the potential impact of a planned surgery might be on the member and their family.

We are advocates for our members.
 
But an equally important part of the process is to conduct follow up communications with the provider, to get any clarification that might be needed on the treatment plan and any rehabilitation to make sure that the care that our members receive is medically appropriate and done in an appropriate time frame by the most appropriate provider.
 
Additionally, if we have a patient that is hospitalized, we are working with the hospital’s case management team or social workers to ensure that everything our member needs is in place, so that the member’s course of treatment continues when that member is ultimately discharged from the hospital. Discharge planning is crucial for reducing the chance that the member will need to be re-hospitalized.
 

We Stick Around

The time after discharge can be pivotal for members, and we are there for them. Our in-house nurses check in on their symptomsand medications to make sure they stay engaged with their providers and that they understand their options for treatment for any complications that may arise. We strive to empower members, through our continued assistance, to take charge of their healthcare.
 
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Just as we continue to be a resource for members after hospitalization and try to limit hospital re-admission, we are also looking into ways to prevent the need for a hospital stay in the first place. Through our data analytics vendors, and access to their vast aggregations of data, we are able to take a holistic view of our members—before illness—to identify members who we can help through early intervention. Through the data, we can spot members with risk factors, such as unfilled prescriptions or missed doctor’s visits, so we can help them--before they need help--so they can maintain healthier lives.
 

The CoreSource Difference

Healthcare Management is one way that CoreSource is different. We recognize that our clients have many options for a healthcare management provider, but we believe that our caring spirit and our dedication to the holistic health of our members and clients sets us apart. We would love to have the chance to demonstrate the value of CoreSource Healthcare Management, and the difference it can make in the lives of your clients and their members.

Contact us to find out more about how our CoreSource Healthcare Management team can help employers and members today.

Posted on May 02, 2019

How We Bring New Products to Life

How does CoreSource bring new products to our customers? Pamela Cowan, our Senior Director of Product Support, explains the process on the CoreSource blog

Posted on April 04, 2019

Cross-Plan Offsets: Why we keep them Off-Limits

Recent news has cast a new light on the insurance carrier practice of cross-plan offsets, and its many drawbacks for employers. At CoreSource, we don’t engage in cross-plan offsets; just one more reason self-funded benefits are a win for our clients.

Posted on April 02, 2019

Our 2019 Summit and “Benefits Beyond Benefits”

The 2019 CoreSource Summit brings our team together for three days of planning, sharing insights, and building a company that delivers “Benefits Beyond Benefits.”

Posted on March 29, 2019

How We Make Innovation Work

At CoreSource, we have the flexibility and experience to meet our customers’ needs through innovation. Our Vice President of Operations, Jennifer Natalie, explains how we do it

Posted on February 27, 2019

Moving the Needle: Client Management

Client management is not for the faint of heart. But it is incredibly rewarding.
 
Every day, our clients look to us for help with all kinds of questions about benefits, and how to navigate this often complex industry. Each request from our clients is chance for us to improve their lives, and the lives of their clients. Members, brokers, employers—they each have unique needs that we can help them with, no matter how big or small the request may be. This is what client managers live for: the opportunity to make a positive difference in the lives of others.
 

2018 Year in Review

We covered a lot of ground on the CoreSource blog in 2018. This year we looked at a wide range of topics, heard from new authors and points of view, and shared a veritable cornucopia of digital engagement tools.

Posted on December 28, 2018

Reference-Based Pricing: a Welcome Disruption

Rising healthcare costs are a complicated issue, and just as there is no single cause, there is also no single “silver bullet” solution. However, reference-based pricing solutions can help reduce the burden on members and employers.

Posted on December 27, 2018

Video: Healthcare Management Delivers for Clients and Members

We’re pretty proud of our Healthcare Management team and the work they do. Watch our video to find out more about the team and the results they deliver.

A ‘client-first’ mindset is second nature for us

Adopting a client-first attitude is never easy. It requires a sea change in a company’s culture, but the rewards for the company are staggering. At CoreSource, we pride ourselves on anticipating client needs, bringing a collaborative attitude to the relationship, and maintaining total honesty and transparency in our client relationships. Delivering in those three key ways is the foundation for a client-first mindset.

Posted on November 20, 2018

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