PATH ALONG Reduce Readmissions Alarm Sounds

PATH ALONG is an original Wisconsin model (service set) that connects inpatient providers to community staff who support the patient during health system transitions.  PATH ALONG inserts a fully operational service set with scheduled evidence based loops that drive quality.  PATH ALONG consists of three services thoughtfully selected out of a certain amount of evidence to deliver subsequent contact on a needs based assessment.

1. Inpatient advocacy provides a staff person to accompany the person on their inpatient stay.

2. Temporary help with a scheduled day surgery.  Staff accompany the person to the hospital for the procedure and follow the patient in the home setting until the senior can get by alone.

3. Crisis intervention and transitional counseling provides a staff person who helps the family with an immediate and long term plan.  The focus is to bring needed service to the person.

This menu of three services is an inpatient providers answer to reducing hospital readmission rates.  Simple referrals to help the hospitalist fulfill their continuity of care role.  The focus being on care transitions.

This is important because (CMS) The Center For Medicare and Medicaid believe that all hospitals should be working toward the goal of reducing readmissions on an ongoing basis regardless of perceived constraints.  (CMS) Center for Medicare and Medicaid has not identified a need to postpone the implementation of the readmission payment adjustments. 

Hospital industry representatives have argued that reduced reimbursement should be used only for aspects the hospital system can control.  This costly readmission difficulty is not being seen as something only a hospital can solve.  Hospital system planners are being required to reach out to the community providers for a collaborative solution. 

PATH ALONG is an original Wisconsin model that utilizes a collaborative approach to managing the identified risk with health system hand offs.   Simply call 608-432-4286 to schedule an interview.