High touch care management program will manage the entire post-acute care continuum and help prevent avoidable readmissions
naviHealth and Health Alliance Medical Plans recently announced the expansion of their collaboration in offering post-acute care management services to Health Alliance Medicare Advantage members. This expanded risk-based management services agreement will go into effect May 1, 2013.
The partnership will utilize naviHealth’s proprietary clinical decision support technology and field-based Care Managers to manage Health Alliance’s members across the post-acute care continuum and prevent costly preventable hospital readmissions.
“We look forward to working with Health Alliance to help their Medicare Advantage plan members receive personalized care plans in all post-acute settings, which will ultimately drive an improved rehabilitation process for these patients and help reduce avoidable hospital readmissions,” said Clay Richards, naviHealth President. “By expanding our relationship we will be able to bring to bear the full benefits of our unmatched evidence-based analytics and face-to-face patient engagement model. As greater coordination of care is increasingly being recognized as a key driver of improved outcomes and cost savings, this type of comprehensive partnership simply makes sense and has the potential to be extremely valuable for all stakeholders involved.”
naviHealth has been managing post-acute care in the skilled nursing facility setting for Health Alliance since 2010 with excellent results. Under the expanded program, naviHealth will engage patients and care teams starting in the hospital to understand the best options for rehabilitation and skilled nursing services. naviHealth’s Care Managers work with patients, caregivers and providers to establish personalized rehabilitation goals and measure progress towards these goals until a patient is successfully transitioned back to the community. naviHealth will also work with members to coordinate care setting transitions and help prevent avoidable readmissions up to 60 days post hospital discharge.
“Health Alliance is pleased to offer this range of expanded post-acute services, to help our members get the right care in the right setting,” said Dr. Robert Parker, Health Alliance Chief Medical Officer. “Our partnership with naviHealth has delivered clear outcomes benefits – helping make our members healthier and our provider partners more efficient. We look forward to working with naviHealth on a larger scale.”
From 2006 to 2011, Medicare expenditures on post-acute care increased 46% to $63.5B. MedPAC has pointed out evidence of post-acute inefficiencies noting substantial variation in post-acute care spending within condition and across geographic areas. Initiatives to improve the efficiency and outcomes of post-acute care continue to gain momentum as evidenced by CMS’s Bundled Payments for Care Improvement programs and readmissions penalties for hospitals.
naviHealth partners with health plans, health systems, accountable care organizations and post-acute providers to manage the entire continuum of post-acute care. naviHealth utilizes evidence-based protocols and technology enabled services to optimize care and align all stakeholders. naviHealth has over 12 years of experience managing post-acute care and currently serves over one million Medicare lives in 15 states.
About Health Alliance Medical Plans
Health Alliance is a leading provider-sponsored health plan in the Midwest, administering health plans for nearly 300,000 people in Iowa and Illinois. Health Alliance was recently recognized as the top-rated health plan in Iowa for its HMO/POS plan, based on NCQA’s Private Health Insurance Plan Rankings, 2012-2013. Health Alliance also ranks 35th nationally for HMO/POS. In recognition of its exceptional commitment to quality, Health Alliance has maintained accreditation from NCQA for its HMO, POS and Medicare HMO plans since 1997.