Alicare Medical Management Expands Patient Transition Coaching Program to Reduce Readmissions

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Alicare Medical Management is expanding an existing program to reduce readmissions and help patients make a safe and effective transition from the hospital to their homes. AMM’s telephonic Patient Transition Coaching Program is unlike any service currently being provided under the umbrella of utilization management, discharge planning, case management or disease management. It is specifically intended to address the post discharge needs of patients who are at risk for hospital readmission.

Alicare Medical Management

Recent studies document that as many as 20% of patients discharged from hospitals end up back in the hospital within 30 days

Alicare Medical Management (AMM, White Plains, NY), one of the nation’s leading care management solution providers, and an affiliate of Amalgamated Life Insurance Company, has expanded an existing program to reduce readmissions and help patients make a safe and effective transition from the hospital to their homes. AMM’s telephonic Patient Transition Coaching Program is unlike any service currently being provided under the umbrella of utilization management, discharge planning, case management or disease management. It is specifically intended to address the post discharge needs of patients who are at risk for hospital readmission.

According to AMM President Claire Levitt, “These are the patients we want to address; the ones who fall through the cracks of other programs and too often end up back in the hospital.” She noted that typical patients for AMM’s program would be those discharged post surgically, as well as patients with congestive heart failure, chronic obstructive pulmonary disease and various cardiac conditions.

AMM’s telephonic Patient Transition Program service begins with outreach by one of AMM’s Registered Nurse (RN) Health Coaches. Immediately after patients leave the hospital, they are contacted by an RN Health Coach who assesses their health status and identifies any potential problem areas. A key role of the RN Health Coach is to make certain each patient is properly informed about essential follow-up care and self-management requirements, has their medications and understands when and how often to take them, is properly educated about potential problems, and knows when to reach out to their physician. When appropriate, the RN Health Coach will contact the physician for additional information, intervention and to coordinate follow-up care.

The program is available on a standalone basis or in conjunction with AMM’s utilization management programs. AMM can work with clients to develop referral criteria to identify appropriate cases for their patient population.

“Recent studies document that as many as 20% of patients discharged from hospitals end up back in the hospital within 30 days,” said Ms. Levitt. “Many of these costly readmissions result from a lack of follow-up care or the patient’s inability to understand and follow their physician’s directions. With proper care coordination following discharge, many of these costly readmissions can be prevented.”

Under the recent federal healthcare reform legislation, the “Patient Protection and Affordable Care Act,” reducing readmissions was identified as a key cost management initiative, even mandating reductions in Medicare payments for preventable hospital readmissions.

Fees for AMM’s Patient Transition Coaching Program are based on a one time case rate for each enrolled patient which covers all short-term services including the full assessment and evaluation of the patient’s status and needs by a RN Health Coach, patient education, and patient monitoring in the first four week period following hospital discharge.

For additional information, contact: 1-800-863-8868 or sales@alicaremed.com.

About Alicare Medical Management

Alicare Medical Management (AMM), an affiliate of Amalgamated Life Insurance Company, is a national leader in developing care management solutions that promote cost savings and patient satisfaction. AMM’s call center is open 24-hours a day, 365 days a year to provide maximum access and assure optimum program effectiveness. The Company’s services include: 24-hour Nurse HelpLine, Utilization Management, Maternity Management, Case Management, Disease Management, Health Coaching and Wellness, Independent Physician Review, Medical Claims Review and Hospital Bill Auditing. AMM holds four URAC accreditations for Utilization Management, Case Management, Health Call Center and Independent Review. For more information, visit: Alicare Medical Management

About Amalgamated Life Insurance Company

Founded in 1943, Amalgamated Life Insurance located in White Plains, NY is now one of the nation’s leading privately-held companies. Under the direction of President and Chief Executive Officer David J. Walsh, the Company has maintained an unwavering commitment to the highest standards of service quality, earning it an “A” (Excellent) rating from A.M. Best Company for the past 34 consecutive years. In addition to Alicare Medical Management, Amalgamated Life’s affiliates include: a property and casualty insurance brokerage, a third-party administration company, a computer outsourcing company, and a printing and graphics company. For more information, visit: Amalgamated LIfe Insurance Company

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Kay Spalding
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