Banner - University Health Plans has partnered with Rovicare, Inc. to transform patient care coordination across the organization.

Many chronic diseases can be a life alerting burdens for patients that hugely impact their quality of life. While it may be easy to write off these diseases as bad genetics or simply bad luck, the truth is that most can be prevented. Healthy lifestyles paired with preventative healthcare screening measures can dramatically reduce the risk of chronic disease. 

Interventions have been put into place that involve multiple components to successfully reduce readmission rates for patients discharged to home.

Study results published in JAMA Internal medicine identify reduce readmissions and emergency department (ED) revisits, and higher ratings of care compared with inpatient hospitalization.

Implementing a hospital discharge program in nursing home settings increases care quality, care coordination, and patient outcomes, researchers found.

The vital care coordination process synchronizes the delivery of a patient’s health care from multiple providers and specialists.

This can be done with broad approaches commonly used to improve health care delivery and using specific care coordination activities.

Despite benefits, Providers and Payors resist "Hospital at Home" programs

An informal poll showed many Hospitalists didn't even know they were part of an Accountable Care Organization.

ACOs are transforming management of hospital discharge through relationships with preferred skilled nursing facilities (SNFs) to address the high magnitude and variation in spending on post-acute care.

Drug events, infections, and procedural complications are just a few adverse effects some patients experience post-discharge.

CMS interested in considering adding patient satisfaction scores while evaluating efforts to increase transparency for consumers.

This study found a correlation between appointments kept post-discharge from in-patient psychiatric care and readmission.

Continuity of care, including communication with outpatient providers, may be especially important for patients who were not engaged in outpatient care prior to admission.

Proper discharge planning should be completed and documented before any discharge is done from MHEs, as mandated by the Mental Healthcare Act 2017.