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Kang is the former CMO of the Centers for Medicare & Medicaid Services (CMS). The Chicago-based WellBe offers home-based medical care services to patients who are facing multiple complex health challenges. Home health agencies existed then, and it was covered by Medicare. That’s from a traditional Medicare perspective.
Utilizing data and multi-component interventions to identify patients at high risk for readmission shortly after hospital discharge is essential for reducing rehospitalization rates. Understanding Hospital Readmissions Hospital readmissions are a significant concern in the US healthcare system, with approximately 19.6%
The ability to deliver higher-acuity care in the home is now table stakes. That’s especially true for health plans and health systems following the introduction of the COVID-related Acute HospitalCare at Home Waiver by the U.S. Centers for Medicare & Medicaid Services (CMS) in November 2020.
“We knew that, from a continuum of care perspective, we needed to be able to do more, for not only our referral sources, but also for our patients,” he said last week during a panel discussion at Home Health Care News’ FUTURE conference in Nashville.
So that’s a case in point, and I’ll share a little story about this, but I would say that before we end up in your ERs, our primarycare providers have an opportunity that needs to be formally presented. The manner in which I have to communicate with my mom’s primarycare provider is woefully behind.
Not for a hospital, it wouldn’t be that much, but whatever it is. $14 Preston (11:16): Alternative insurance models, I mean, we see it with direct primarycare, they’ve opted. Not for a hospital, it wouldn’t be that much, but whatever it is. What goes into all that?” 14 billion or something.
And as you know, obviously a huge percentage of healthcare spending is funded through Medicare, Medicaid, Tricare, the VA system, and these are all programs that are covered by the False Claims Act. Preston (11:16): Alternative insurance models, I mean, we see it with direct primarycare, they’ve opted.
So medication and health compliance, discussing care plans, and certainly even follow up to the primarycare provider or that referring physician is impactful. For hospitals, it’s probably a little different as far as what ultimately persuades them. Here’s why you need to be on these particular medications.”
We’ll get to WelbeHealth in just a second, but I am curious, did you always have this clear interest in home- and community-based care models, or did you gradually get into these areas? We know that in health care the satisfaction can be very low. The disenrollment rate for PACE is 5% less than the Medicare Advantage plans.
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