October 17, 2021
During the COVID-19 crisis, telehealth and virtual care innovation have enabled millions of Americans to access critical care and manage chronic conditions while minimizing exposure. Yet even before the pandemic, nonprofit, community-based health plans have been shaping the evolution of consumer access to Care Anywhere — beyond hospitals and clinics.
Through collaboration with local provider partners and health systems, the Alliance of Community Health Plans’ (ACHP) member companies have enhanced options for consumers to access care when and where they choose. Meeting consumers where they are with the services they need leads to improved care coordination, expanded access and reduced costs — improving value in the health care system.
Whether by phone or email, by video or remote device, in the home, in community centers or at a clinic or hospital, ACHP plans provide convenient, high-quality options for Care Anywhere:
- Geisinger Health Plan enrolls at-risk patients in the Geisinger at Home program to receive regular home visits to manage conditions such as kidney disease, heart disease, cancers and dementia. Geisinger’s telehealth program also offers access to 70+ specialties and connects patients to a local physician, clinic or hospital.
- Presbyterian Health Plan, which serves a large Medicare population, offers in-home care with Hospital at Home services. Compared to patients treated in the hospital, the program has resulted in fewer readmissions (3.2 percent vs. 9 percent), shorter average length of stay by more than a day and a HCAHPS satisfaction score in the 99th percentile. Patients with advanced illnesses are transitioned to the Complete Care program for long-term home-based care and early interventions, resulting in $11,103,030 in estimated savings in emergency department and hospital costs alone.
- SecurityHealth Plan provides daily in-home visits through its Home Recovery Care (HRC) program for acute care patients. The care team can perform X-rays, EKGs and lab work and provide rehabilitation services, speech and occupational therapy, nutrition counseling and necessary medical equipment at home. HRC patients have experienced a 37 percent shorter length of stay and 44 percent fewer 30-day readmissions than those treated in the hospital — all while reducing costs by an estimated 15 to 30 percent per episode.
- UPMC Health Plan uses smart technology to remotely track patients’ heart vitals at home, monitored daily by a team of nurses. This innovative approach reduces hospital readmissions for heart failure patients and increases patient satisfaction to over 90 percent.
Placing patients at the center, ACHP members’ adoption of important care delivery flexibilities empower consumers while improving access to high-quality coverage and care.
Learn more about ACHP members’ efforts to expand access to Care Anywhere here.
