AmeriCare gets ahead of curve

Wednesday, August 31, 2011

PONTIAC, Mich. -- AmeriCare Medical in August launched a pilot program that will allow the provider to pick up where the hospital leaves off.

The "Total Care Experience," formed in partnership with St. Joseph Mercy Oakland, a hospital in the Trinity Health System, seeks to reduce hospital readmissions and cut Medicare costs.

"It made sense to get a program going now," said Stacey Murphy, vice president of corporate development for AmeriCare.

Beginning Oct. 1, 2012, Medicare payments will be reduced for avoidable readmissions for patients with specific conditions like pneumonia and congestive heart failure.

The way the program works is this: AmeriCare has a patient care liaison onsite at the hospital. The liaison meets with the patient upon admission and checks in during the patient's stay, building a relationship. Upon discharge, the liaison asks the patient a series of questions to assess whether the patient is at risk for readmission. Those who are at risk are followed up with once they are back in the home.

"Sometimes a person can't afford their medications," said Murphy. "Or, if they are diabetic, you can give them a really great, easy-to-follow diet, but they don't have a stove. We uncover those details."

Uncovering those details and intervening when necessary go a long way toward keeping that patient from being readmitted to the hospital, said Murphy.

"Patients don't want to go back to the hospital and we are finding this program is the solution to keeping them at home," she said. 

While there is currently no Medicare reimbursement for these services, AmeriCare believes the program will pay off down the road, when it expands it.

Other payer groups have a stake in reducing readmissions as well, said Murphy.

"Almost every entity will benefit," she said.