Pilot Sees 15.7% Reduction In Readmission Rates
By Christine Kern, contributing writer
Increased enrollment in community health programs spurs inclusion of Maryland HIE.
As a result of a year-long pilot program, Curaspan and Amerigroup Maryland have announced a 15.7 percent reduction in readmission rates for high-risk members across five Baltimore hospitals. These findings haveled to the extension of the program for an additional twelve months.
The goal of the pilot program was to encourage collaboration by payers, hospitals, and community providers to proactively enroll high-risk members in community health programs prior to hospital discharge, thus reducing the chance of readmission. The pilot included the monitoring of over 2,000 high-risk members, the delivery of over 24,000 notifications, and the enrollment of some 200 high-risk Amerigroup members in community health programs.
Amerigroup utilized Curaspan’s care transition technology and its established network of hospitals to receive electronic notifications when high-risk members presented at any of the participating hospitals. The notifications provided Amerigroup with opportunities to connect the hospitals with specialty community providers to enhance member care management.
“Amerigroup and Curaspan were able to dissect a very complex and costly problem into segments that could be addressed by practical and achievable solutions ultimately driving better collaboration between payers, providers and members,” explained Rob Fisher, VP of Hospital Sales at Curaspan.
“We were able to work with five hospitals, four provider organizations, and Amerigroup to significantly impact the care of complex members by bringing about transparency and collaboration with the use of Curaspan’s technology,” Fisher added.
Using Curaspan’s care transition technology, Amerigroup’s network of hospitals in Baltimore was able to receive electronic notifications when high-risk members presented at any of the five participating hospitals. Then Amerigroup could connect the hospitals with specialty community providers to enhance member care management.
Susan Garcia, Director Health Care Management Services, Amerigroup, explained, “Hospital care team members can now collaborate in real-time with our payer care team, which has resulted in greater enrollment in community health programs and reduced readmissions.”
Encouraged by the pilot’s success, the program has been extended for 12 months and will also incorporate data from the Chesapeake Regional Information System for Our Patients (CRISP), a leading health information exchange serving Maryland and the District of Columbia. This move will significantly expand the program’s coverage and has the potential to increase transition interventions and improve patient outcomes.