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How Health Plans Can Reduce Readmissions

Orderly pushing patient in a wheelchair

Last year, more than 2,500 hospitals faced CMS penalties for high readmission rates. As an insurer, you feel dependent on providers to keep these numbers down, but insurers can do more than they think.

Here are just some of the ways health plans can help reduce readmissions.

Integrate Care Follow-Up

Care follow-up doesn't have to be solely up to the provider. Make it an integral part of your health plan instead with automated appointment reminders, appointment follow-up notifications, care instructions and more all through a digital health platform. This can be done automatically when you use PatientBond's Digital Health Platform and it can be optimized to motivate patients to take action on their health outcomes. Plus, psychographics, which determines what motivates patients to act on their health, are automatically built into the platform.

Health systems using PatientBond have successfully reduced hospital readmissions by up to 90% for health conditions such as congestive heart failure, atrial fibrillation, COPD and a form of spinal surgery.

It goes to show that a little patient engagement can go a long way to reducing readmissions.

Include In-Home Post-Op Options

Home healthcare has grown in popularity thanks to the pandemic. Providers like HCA are trying to get in on it by buying out major companies and so are insurers like Humana. With more health systems, physicians and other providers offering these services, it only makes sense for insurers to integrate them into their health plans.

Using a digital health platform, you can incorporate the care follow-up protocol with in-home post-op services. A patient could get reminders on when their home health aide arrives, what their visit will entail and what they need to do care-wise when the aide isn’t there. This could be especially helpful for caregivers of older relatives who may be managing a lot of this.

If the provider and the insurer work together to improve patient health outcomes, then the readmissions are bound to go down.

Determine Patient’s Top Care Needs

Patients may have additional health needs beyond their current care plan. In some cases, this can increase readmissions if they hadn’t addressed these concerns previously, but in the long run, it’s best for improving health outcomes.

The PatientBond Insights Accelerator™ confronts this by looking at healthcare consumer data compiled from across the U.S. This data includes psychographics and specifically, the certain conditions patients are likely to deal with based on their psychographic segment. It also includes what conditions patients might want to treat.

For example, Direction Takers are statistically more likely than any other segment to take a prescription for depression. Knowing this, health insurers may recommend medication as a treatment option for these types of patients who are diagnosed with depression. On the other hand, if a Balance Seeker patient is diagnosed with anxiety, you’d want to recommend treatment options outside of taking medication since they are statistically more likely than any other psychographic segment to avoid prescription medications to treat it.

It’s important to have this understanding of what a patient needs because when you follow their care preferences to treat a condition, they are more likely to follow through with them. And when patients stick to their care routine, they get better and don’t have to get readmitted to the hospital.

Learn more about how you can lower readmissions by downloading our free whitepaper.

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