Exchange Navigator CA-NAV-13-001 Letter Of Intent

Home Care Path LLC

810 Cedar Street

Wisconsin Dells, WI 53965

lkutzke@homecarepath.onmicrosoft.com

608-432-4286

www.homecarepath.com

04/29/13

This is letter confirming intention to apply for CA-NAV-13-001 Exchange Navigators Grant. Home Care Path LLC is a community based organization known for delivering supportive care to seniors in Wisconsin.

Home Care Path LLC utilizes copyright content through the PATH ALONG model to help seniors with transitions of care. The result being a reduction in hospital readmissions and an improved inpatient experience. A big part of this work is assisting families to transition from private to public health delivery pay sources.

Home Care Path staff believe individuals in Wisconsin would benefit from our participation as support navigators with the evolving health insurance exchange.

Home Care Path

Your Home And Medicaid

Medicaid is a Federal and State Health Insurance plan for individuals without the income to pay for medical care.   As individuals get older, the ability to earn income can go down, while the need for medical care can go up.

Today , seniors can be eligible for Medicaid while still owning their own home.  If the senior lives in their home this is an excluded resource.  A primary residence does not count as long as the elder resides there. 

The most common mistake families can make when planning for medical care needs is to sell the seniors home.  The proceeds from the sale of the home can turn an exempt asset in to a countable resource. 

Managing the seniors health care needs while residing in the home is a way to retain wealth for the family.   One of the care coordinators primary secrets is: If you have not been receiving supportive care in the home setting you are not at the level that would require a geographical move in to a memory assisted dwelling.

You are cordially invited to download your free PATH ALONG app today

http://appsmakerstore.com/appim/j6kcdet8xvwk4s


 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.

Hospital C. diff Fears TRU- D Smart UVC

Clostridium Difficile (C-diff) is a pathogen that loves to hang around on the hospital surfaces. C-diff starts with cramping and loose stools.  This can lead to fever, blood tinged stools, increased frequency causing dehydration and weight loss.

The Centers for Disease Control (CDC) funded a study to test the effectiveness of TRU-D Smart UVC to combat C-diff.  The TRU-D Smart UVC is a portable disinfection system developed by Philips Health Care (Royal Philips Electronics).

TRU-D Smart UVC works by emitting UV-C light throughout the room.   The UV-C light modifies DNA structure of an infectious cell so it cannot reproduce and therefore cannot colonize and spread.  Technology allows the controls to adjust to best meet the varied size and shape of the room.  This is proven to disinfect surfaces of the C-diff pathogen.

Innovation to reduce the risk of the patient population becoming infected with the Clostridium Difficile (C-diff) pathogen.  This is good news on the health care front.

You are cordially invited to download your free PATH ALONG app today

http://appsmakerstore.com/appim/j6kcdet8xvwk4s


 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.

4 Most Important Changes Created With Readmission Reduction Efforts

The Centers for Medicare and Medicaid (CMS) have enacted policy to change the way service has been delivered in the hospital setting.   Public (Medicare) funds and private (commercial insurance plans) health insurance plans will no longer reimburse contracted providers for the full amount of a re-hospitalization.  Hospital readmissions are no longer an accepted part of medical practice.

This is the health system payers current means to manage the out flow of investment.  The payer is defining the skilled inpatient need as a separate part of the patients treatment and recovery experience.   The payer is designating the skilled inpatient services as different from the health care community providers can deliver at a lower rate of reimbursement. 

The expected result looks like:

1. a decrease in the number of patients readmitted to the hospital within 30 days of discharge

2. a decrease in the number of patients staying over night in a hospital as out patient observation

3. a decrease in the number of patients returning to the emergency department 14 days after discharge

4. a decrease in skilled home care (RN, PT, OT, ST) performing supportive care tasks in the home



For this to work safely the inpatient providers are challenged to forge a strong collaboration with the growing number of community providers serving the same population.  This looks a bit different to staff employed throughout the inpatient setting.  Day surgery is now expected to engage the patient and family to document a plan of adequate support for the scheduled procedure.  The need exists and the inpatient service does not deliver that care as part of the procedure.  The connection with the providers in the community capable of meeting the need is much more important. 

To add to the mix of system adjustment is the variation in pay sources.  Medicare and private commercial health insurance plans do not completely reimburse the hospital for the service delivered.  The patient is expected to contribute through deductibles, copayments, add on policies, and private payment.  Now the insurance  payer is explaining to the hospital staff, the patient population,  and community providers the specific service and frequency that can result in a reimbursement.

So, despite an identified need for extra assistance with tasks like bathing, dressing, eating, toileting, remembering medications, ambulation, transfers, errands, a clear pay source is not available with the brief inpatient registration process.  But, hospital staff will realize that help with these daily tasks are part of reducing readmissions, repetitive emergency room visits, and outpatient observational stays.

Hospitals upon seeing the elders need will make a referral to a community (www.homecarepath.com) based organization with staff available to provide the extra support.  Readers are encouraged to watch the health care system as these changes unfold in our community. 

You are cordially invited to download your free PATH ALONG app today

http://appsmakerstore.com/appim/j6kcdet8xvwk4s


 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.


 

PATH ALONG Improves Coordination Among Providers

The Centers for Medicare and Medicaid (CMS) and traditional commercial insurers are informing the claims department of all hospitals they will not reimburse for a readmission due to poor coordination among providers.  Hospital readmissions are no longer an accepted part of the inpatient delivery process.

Wisconsin's PATH ALONG is an original model that fosters collaborative relationships among providers across care settings.  The structure leads the patient to define specific participants in each transition of care.   I will go from seeing Mitchell the hospitalist, to clinic visits with Ann the primary provider.  The dynamic component lists the critical task required to improve the recovery experience.

Confidence with transition decisions improve as community providers activate needed service in a timely fashion.  The secret to successful support is early involvement with a well communicated vision focused on recovery. 

Wisconsin's PATH ALONG model provides the structure capable of accommodating a variation in network size and the presentation of multiple public or private pay sources.   Inpatient staff quickly adapt to the style which enhances communication and productivity. 

You are cordially invited to download your free PATH ALONG app today

http://appsmakerstore.com/appim/j6kcdet8xvwk4s


 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.

The New Health Delivery Priority

Preventing readmissions is the new priority with a hospital stay.  Home Care Path's new PATH ALONG model makes readmission free recovery key.  The PATH ALONG model utilizes a predictable process, ongoing care coordination, and easy assess to support assistants to make recovery simple.

This innovative inpatient process involves personal preference with valuable transition specific insight to formulate an achievable plan for recovery.  PATH ALONG's copyright content is beneficial regardless of the size of the network or the variation in the pay sources.  This is prevention at the point of service to support a re-hospitalization free recovery. 

The PATH ALONG model puts a navigation capability that strengthens engagement and fosters self autonomy back in the elders hands.  The PATH ALONG model makes each care transition and identifying a need for a referral simple.  PATH ALONG is an original model from Wisconsin. 

You are cordially invited to download your free PATH ALONG app today

http://appsmakerstore.com/appim/j6kcdet8xvwk4s


 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.

Hospital Readmission Reduction App a good fit

The results are clear, to avoid a re-hospitalization try the new free PATH ALONG App.  The App was recently reviewed by a group of seniors on five important evaluation points. 

Specific: The App moves the patient from the broad intention to avoid a re-hospitalization in to the specific details used to best manage a safe recovery.  The main purpose is to reduce the need for a readmission.

Measureable: The App (PATH ALONG condensed under iFrame) defines the desired outcome with each care transition.  Was the critical task in each transition completed.

Attainable: The comprehensive structure of the App provides a measure of care assurance and keeps the process at a realistic level.  How do we adjust service to best meet the need and maintain health.

Relevant: The dynamic component with each care transition moves the inpatient staff and senior toward effort that strengthens health and well being. The focus is on recovery.

Time bound:  The specific time frame is the point of admission to approximately 30 days post discharge.  The seniors noted that the process was ongoing, with adjustments being made daily throughout the listed portion of time.

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Elders Do Better With Home Care Path Attending To Individual Needs

Home Care Path and Wisconsin's PATH ALONG model incorporate patient centered skills and action triggers to help improve the seniors health.  Operating on the data that demonstrates seniors do better with staff who pay attention to their individual needs and home situations.

Home Care Path and Wisconsin's PATH ALONG model delivers a supportive care approach for the senior across varied settings of delivery.  This is important, as many elders express feeling most vulnerable when a change in condition requires them to seek inpatient medical care. 

 Staff employed in the medical setting are being required to care for a  higher number of patients and stay focused on completing tasks that meet regulatory guidelines.  Home Care Path and Wisconsin's PATH ALONG model work with the senior to customize inpatient to outpatient medical recommendations to best meet the elders individual needs and home circumstances.

Hospital and clinical staff appreciate the input supportive (www.homecarepath.com)  care can deliver to the underlying causes contributing to the seniors deteriorating health.  This is collaboration across the community.  Understanding of the elders needs becomes more apparent with a supportive care presence with the medical providers interview.  This is truly patient centered care. 

Wisconsin's PATH ALONG model establishes an effective plan for recovery with each care transition throughout the inpatient stay.  This is a powerful application to improve individual participation and deliver a measure of care assurance. You are cordially invited to download your free PATH ALONG App today!

http://appsmakerstore.com/appim/j6kcdet8xvwk4s 

Wisconsin Touts Secret Weapon To Reduce Hospital Readmissions

Nation wide hospital readmission rates have remained difficult to reduce.  Serious health system planners report the effort requires a consistent inclusive collaborative approach.   Regardless of the difficulties (CMS) The Centers for Medicare and Medicaid have concluded that a readmission to a hospital setting within 30 days of discharge is unacceptable.

  Wisconsin medical providers and the community have turned to a recently released copyright process designed to prepare a clear path for each care transition.   Authorized for distribution in cooperation with Home Care Path LLC the PATH ALONG App
http://appsmakerstore.com/appim/j6kcdet8xvwk4s  is available for free download through the appsmakerstore.

Information on the PATH ALONG App facilitates an assessment risk for a rehospitalization.  The PATH ALONG condensed communicates concise instructions for improving recovery with each defined transition of care.   Residents of south central Wisconsin have access to a supportive care worker for 20.00 per hour.  This is technology, helpful information, and access to service in the individuals hands. 

Seniors are reporting they love the abbreviated aspect and would not go in to the hospital without their PATH ALONG App. 

Dean Merge To SSM and Hospital Readmissions

Dean of Wisconsin has announced plans to merge with SSM of St. Louis.  SSM is a huge vessel of unity that forms one of the largest networks of medical providers in the United States.

Federal health policy has tied reimbursement to measures of quality and efficiency.  Larger systems collaborating in a more integrated delivery of care practice excel in performance measures.

Hospital readmissions involves the discharge from a hospital and a re-hospitalization within 30 days of the last discharge.   Public health care payers (Medicare) will progressively reduce the level of reimbursement for a hospital readmission over the next few years.   This is federal policy shaping regulations to utilize payment to change health care delivery models.  Hospital readmissions within a 30 day time frame are no longer an acceptable outcome for hospital providers.

Rural community hospitals are more likely to serve a larger number of patients using Medicare as a pay source.  A greater percentage of the total number of patients being served will have public (Medicare) money as a pay source.   With (CMS) The Centers for Medicare and Medicaid progressively reducing the amount reimbursed for re-admissions within 30 days the annual budget decreases.  The risk to a rural community hospital is a loss of a location. 

To manage this risk health care providers will seek to attach their practice to ever larger systems of health care delivery.  This moves troublesome risk in to a larger system of health that spreads it to a minimal fiscal adjustment.  Service areas producing larger margins of profit can contribute to support service areas producing lower margins of profit. 

The population continues to receive the convenient services a rural community hospital location can provide.  With these larger systems delivering procedures the consumer will begin to expect a known process for the received health product regardless of the geographical residence.  Change is occurring and Home Care Path encourages families to watch this transformation as it unfolds.

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Health Insurance January 2014

 Beginning  January 1, 2014  insurers can no longer decline your health insurance application based on your medical history.   The use of diagnostic disease process as a measure of risk to support a higher premium payment is no longer valid.   Legislative regulation now folds this risk associated with pre-existing conditions in to the population of payers. Consumers who need the most help paying for their medical care now have access to health insurance products.

Consumers with a pre-existing condition were often denied coverage if that coverage had been sought as an individual in the health insurance market before March 2010.   Now health status is not an option for a rate increase. Consumers will still experience a rate increase with advanced age, tobacco use, and depending on your geographical residence.

Under the (ACA) Affordable Care Act as of January 1, 2014 all health insurance plans are prohibited from discriminating against or charging higher premiums to a consumer on the basis of a pre-existing medical condition.

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

PATH ALONG Links ACO to Supportive Care

Accountable Care Organizations (ACO) are networks of physicians and other health care providers that work together to improve the quality of health care services and reduce Medicare cost for a defined patient population.  An Accountable Care Organizations stock in trade is care coordination.  Coordinating (making referrals to community service providers) care is the way the Accountable Care Organization exercises the service portion of their participation in the health care system.

The enacted health care law (The Patient Protection and Affordable Care Act of 2010) under section 3022 and (Medicare Gain Sharing Program) section 1899 facilitates the option for health care providers to form Accountable Care Organizations.  Staff in Accountable Care Organizations coordinate supportive in home assistants (www.homecarepath.com) as a way to demonstrate taking responsibility  for the over all care of their Medicare beneficiaries.  This improves the quality of the recovery experience while preventing a re-hospitalization.

Wisconsin's PATH ALONG model collaborates with (ACO) Accountable Care Organizations to help save (CMS) The Centers for Medicare and Medicaid dollars on four familiar streams of health care reimbursement.  Briefly the PATH ALONG model utilizes an advanced supportive service to reduce:

1. Reduce readmissions with recovery focused transitional assistants.

2. Reduce outpatient observational stays with rapid attach supportive assistant to accompany the senior home and maintain close contact with the medical team.

3. Reduce the repetitive emergency department visit loop with supportive assistant accompanying the senior home and delivering in home tasks until household is stable.

4. Reduce utilization of skilled medical providers to perform in home tasks a lower cost supportive care agency (www.homecarepath.com) is capable of doing.

The Accountable Care Organization receives from Medicare a share of the savings for participating in these simple strategies known to produce improved quality, fewer hospitalizations, and elimination of unnecessary expenses.  Accountable Care Organizations (ACO) benefit from the knowledge that PATH ALONG staff deliver a comprehensive service in line with their public funded mission.

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

PATH ALONG How Priority Fits With Hospital Readmissions

The two facts participating in the fastest change with the health care system involves the aging of our population and the increased number of users with the Accountable Care Act creating ready access to a health care pay source.  Individuals are living longer and we experience a higher need for health care service in older age.   More people having access to health insurance means more people using the health care system. 

Being at the initial stages of this change the health care system and the population will experience some instability (hospital readmissions) as community organizations adjust.  The two most obvious components regarding this change can be explained as:

1. Available funds.  Both public and private health insurance plans will declare a shortfall in money as risk reserve to guarantee health providers who perform covered benefits will be reimbursed in a timely manner.

2. Available staff.  Health care providers will experience a consistent increase in the number of users challenging organizations to have adequate staff to safely meet the service need.

The current response is more defined constraints on payment and service.   This reduces the outflow of the two resources listed above adequate funds, and adequate staff.  This will look like:

1. The patient need is matched with the provider skill level.  Public and private health insurance plans will not pay a Medicare certified Home Care Agency to send skilled staff to perform (ADL's) activities of daily living and  (IADL's) instrumental activities of daily living for a need that can be safely met by a supportive (www.homecarepath.com) in home care agency.

2. Equal reimbursement across chosen settings of care.  Public and private health insurance plans will reimburse providers at a level of defined (coding intensity) need.  So even if the senior spent a night in the hospital under an observational outpatient claim category, the reimbursement could be challenged upon audit with the proper provision being home with supportive care agency and close contact with medical staff.

This will be a bit confusing for the staff participating in the health care delivery and the consumer receiving the health care service.  It will appear different. Hospital readmissions are no longer acceptable.  The health insurance payers are pushing the community to develop a network of health care provision that can better meet individual's needs.  The one size fits all is transforming in to a how to best meet the need in the most fiscally responsible safe way.  Individual's who make up the community are being asked to participate in a process that  involves being good stewards of available resources (funds, staff) as the payers and providers adjust.

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Physicians Office Underlying Driver Of Affordable Care Act

Long term community health care planners taking a holistic view of the changes taking place in the delivery across America can't help but think physician's office.  The physician's office is where the primary management of an individual's treatment regimen is decided.  This is the one place in the entire system of care delivery that an individual is being served.  Yet , an undesired effect of the employer paid insurance plan has been a stagnation of reimbursement for the physician office visit.

The (ACA) Accountable Care Act facilitates changes in the existing health insurance market shifting the focus from the employer back on to the individual.  Now the health care system provides more individualized care shifting from a model of delivery designed to please the employer.  The elevation of the primary care physician and the individual patient is an important theme emerging to the forefront of health care delivery in America.

Left to expand without direction the health care system's strongest delivery involved segmented  connections of aggressive treatment for acute symptoms.  Disconnected, competing health treatment facilities attacking a late stage disease process to provide evidence for a hefty investment in a technological machine and barrage of potent medicinal remedies.   The result being the bulk of a health care dollar is used on these out of control symptoms of chronic disease.

To effectively treat these symptoms of chronic disease the office physician's realized the need to shift toward a continuous connection of prevention and scheduled interventions across a persons life time. 
Office physician groups determined that to be fiscally responsible money being thrown at the later stages of chronic disease needs to be shifted to earlier intervention.  This looks like a whole different product to the employer groups who were used to having a larger say in how invested money was spent on the population being served.  More frequent patient visits to the physician's office is an important theme emerging to the forefront of health care delivery in America.

To effectively treat chronic disease earlier and save the health care system money the groups of office physicians would need to get hospitals to improve communication.   The end result would be a collaboration in care delivery between the physicians office and the hospital of the patients choice.  The physicians office group embraced the changes in technological communication to forge a productive tool capable of producing a  measure of control in real time across multiple care delivery settings.  This new tool is the (EMR) electronic medical records.  Electronic medical records placed the hospital stay back in the physicians office as portable data.  Your health care providers reviewing your latest medical visits through the physicians office computer is an important theme emerging to the forefront of health care delivery in America. 

So the changes we are seeing in the health care delivery setting involve:
- the shift from employer to individual
-the shift from go to the doctor only when sick to ongoing visits
-the shift to having all your health visits available on the computer

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Private Insurance To Hospital Readmission Reduction Git R Done

The Centers for Medicare and Medicaid (CMS) have enacted policy encouraging hospital's to reduce readmission rates.  Private health insurance plans typically follow in the foot steps of established Medicare and Medicaid guidelines.

Private health insurance plans will formulate contracts for payment based on annual (setting specific) readmission data.  The private health plan ties reimbursement to a goal rate.  The goal readmission rate should compare to health care system accepted national averages.

Upon annual review by the health plan of hospital readmission data an agreement (contract) is made with a listed goal rate as an incentive for the hospital staff to reduce readmission rates.  Unfortunately, the private health plan does not tell the hospital how to reach this agreed upon goal rate.  The expectation is the hospital will Git R Done.

Wisconsin's PATH ALONG model is an ancillary evidence based structure that does not disrupt internal hospital policies and procedures while simplifying care transitions and extending a measure of control beyond the inpatient wall.   PATH ALONG supports hospital delivery to facilitate communication with post discharge providers to help improve care assurance.

The PATH ALONG model generates evidence based solutions for a  hospital contracted with a private health insurance payer who is expecting readmissions to stabilize at the agreed upon goal rate.  The PATH ALONG model is an advanced supportive care agency sharing solutions designed to assist the hospital in meeting private health insurance plan goal rate contracts.

 Home Care Path  www.homecarepath.com and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

 

Microsoft Office 365 High In The Sky Upgrade Continues website and app down

Home Care Path and the Wisconsin PATH ALONG model App continue to be unavailable with the Microsoft Office 365 upgrade.

 Fellow users can access their web site by signing in as "admin" just like before.  There is a little bell on top of the menu bar that is your alerts.  One of the alerts says new features are available for share point team.  Click on "start using them" and it takes you to the website editing screen.  My website button appearing on left.

Home Care Path and Wisconsin PATH ALONG model would like to take this opportunity to thank all the site users for their patience with this mandated process.

 Home Care Path and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.

PATH ALONG Maximize Hospital Readmission Reduction

Wisconsin's PATH ALONG model addresses transitions as a way to reduce hospital readmission rates.  One of the not so apparent transitions is the shift from private funds to public money as a health care pay source.  As a way to stabilize the household, has the senior determined eligibility for the public funded programs. 

PATH ALONG staff work with the senior to facilitate access to public funded health care benefits.   Discussing medical care needs as relates to the Wisconsin Partnership Program, The Family Care Program, or a non-service related pension through the Veterans Affairs to name a few.

A hospital discharge can indicate a change in condition which would call for a benefit review to determine eligibility.  Many elders can qualify for some form of additional help.  Home Care Path www.homecarepath.com and the PATH ALONG model expect seniors to be served by multiple varied community providers throughout the recovery.

Knowledge of how the patient can navigate the available streams of  monetary benefits that flow in the form of  care delivered through public programs can improve the recovery experience.
Connecting the private to public pay sources to assure care is a long term evidence based approach to reducing hospital readmission rates. 

 Home Care Path and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

 

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Home Care Path Web Page PATH ALONG App down with upgrade

Microsoft Office 365 high in the sky cloud based technology will be conducting upgrade April 7-8 on the Home Care Path web site and PATH ALONG App service.  Users will see screen that indicates a limited or no availability during this process.  Administrators of Home Care Path web site and the PATH ALONG app would like to thank online users for their patience with this mandated process. 

Part of the important supportive care service Home Care Path and Wisconsin's PATH ALONG model deliver to the community includes help with transitioning from a private to a public pay source.  This is facilitating access to available resources to help maintain as much money as possible in the household. 

Home Care Path and the Wisconsin PATH ALONG model can be reached at 608-432-4286 or email lkutzke@homecarepath.onmicrosoft.com  Caring for elders across the Wisconsin south central landscape.

Presidential Budget VA Money To Improve Access To Earned Benefits

President Barack Obama and Administration are comprehending the way VA Service provision changes as military families settle back home.  The Federal Government has included a 4 percent increase in the 2014 budget with 2.5 billion aimed to improve access to earned benefits.

Department of Veteran's Affairs  Eric Shinseki acknowledges the wait to receive earned benefits is currently too long and tedious.  The department lists 600, 000 incomplete claims in mid process.  This means families are waiting for benefits needed to maintain a stable household. 

Home Care Path www.homecarepath.com encourages families working through the claims process with a certified VA Specialist to consider using the American Legion Claims Coach App
http://homecarepathseniorcare.blogspot.com/2012/09/the-american-legion-claims-coach-app.html.

This is a tool that provides a structure to the VA claims process and helps families track where they are in the system.  Home Care Path and the Wisconsin PATH ALONG model encourages Veterans to contact their County service officer and work through the process to gain access to the earned benefits.

 Home Care Path and the Wisconsin PATH ALONG model deliver an advanced supportive care service.  Helping seniors in the home, with clinic visits, at the hospital, nursing home and assisted living facility.  Helping seniors downsize with a move in to an adult child's home. 2013 rates are 20.00 per hour.  Simply call 608-432-4286 to schedule an interview.  We can be there when you are working.  We accept long term care insurance.  Services can be tax deductible.  Help with resources and the transition from private payment to public funded programming.  Valuing home and human life.  You are cordially invited to download your free PATH ALONG App, seniors are saying they would not go in to the hospital without their App.

 

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

EOB Explanation of Benefits Post Medical Visit Form

The (EOB) explanation of benefits form comes from your health insurance company.  You should get an explanation of benefits mailing if you have a private health insurance plan, a public (Medicare) health insurance plan, or a health insurance plan your employer chose.  An explanation of benefits (EOB) is a form sent to you by your insurance provider several months after you had a health care service paid by the plan.

Insurance plans exist as large groups of people who all pay in to a fund.  In exchange for the opportunity to be reimbursed for service from this large group, hospitals and clinics deliver care at a lower rate.  The insurance plan negotiates a lower rate of reimbursement with the hospital and clinic providers in exchange for steering the people who pay in to the collected fund for service.

Below is an example of an EOB after a clinic visit with the primary MD about 1 week after a hospital discharge.

Patient:  (name here) Liddy Kass

Insurance ID number: 51 Number assigned to Liddy by her private insurance plan

Claim number: 88 Number assigned to this claim by her private insurance plan

Provider: Marcus Welby MD Name of Liddy's Primary medical doctor

Type of service: Post hospital follow up office visit

Date of service: 01/23/13 day Liddy had an office visit with Dr. Welby

Charge: 150.00 the amount Marcus Welby billed Liddy's private insurance plan

Not covered amount: 75.00, the amount of Dr. Welby's bill that Liddy's private insurance plan will not pay.  The code next to this was 260 which was described on the back of Liddy's EOB as "over what plan allows". 

Total patient cost: 10.00 Liddy's office visit copayment

Amount paid to provider: 65.00 the amount that Liddy's private insurance plan sent to Dr. Welby

The arithmetic: Dr. Welby is allowed 75.00 (his charge of 150.00 (minus) the non covered amount 75.00 (equals) 75.00.  Dr. Welby gets 10.00 from Liddy and 65.00 from her private insurance plan.

The EOB form demonstrates how collected information is diminished and refined for ease of conveying along the system.  Names, codes, numbers, and classifications, are stored and accessible in
the digital medical operating system.  The system values how the visit is recorded as an occurrence.

Wisconsin's PATH ALONG model helps seniors during the hospital stay and with the outpatient treatment visits.  PATH ALONG is a strong arm of Home Care Path a community based organization committed to performing a service that supports the changing needs of an aging population.  You are cordially invited to down load your free PATH ALONG app today

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Who Pays With Outpatient Observational Status

An elder presents at the emergency department with illness.  The ER staff does an assessment and the elders symptoms fall short of needing a hospital admission.  But, the staff is unsure of sending the elder home alone in this condition.  As a means to insure the elders safety the hospital staff may arrange to keep the senior over night in the hospital as an outpatient observational status.

 The hospital doctor and the staff believe the person can stay over night and the Medicare (public insurance plan) can be billed for the service.  The hospital (UR) utilization review committee looks over the notes and agrees the over night stay should be billed to Medicare as an outpatient observational status.  The hospital claims department submits the bill to Medicare and it is paid.

Days later Medicare performs an audit and reviews the claim.  A certified Medicare benefit review specialist determines the over night stay in the hospital was not needed.  Medicare retroactively denies the claim and sends notice to the hospital to refund the previous reimbursement.

The hospital claims department sends notice to the elder that Medicare has refused to pay for their nights stay in the hospital and the consumer is now responsible for paying this bill.   The amount billed by the hospital claims department for the room should not exceed the daily rate for a hospital room and board for semi private room which is about 1554.68 dollars per day. 

The family can divide the daily rate for room and board 1554.68 by 24 hours, which is 64.77 per hour, to figure the hourly expense.  The hourly cost of room and board of 64.77 can be used in comparison to the investment of allowing the elder to go home with supportive care who maintain close contact with the medical team.  The hourly cost for supportive care would be 20.00, this is less than one third the cost of staying in the hospital setting. 

Clearly facilitating the support to allow the senior to go home with help is the more fiscally responsible option.  Home Care Path and the PATH ALONG model communicate this only to inform the community of the way the hospital delivery system currently is operating.  This is an undesired variation in the health care system.   This helps the community to understand the changes taking place on a health care system level and improves their ability to choose safe strategies to achieve health.

Wisconsin's PATH ALONG model helps seniors during the hospital stay and with outpatient treatment visits.  PATH ALONG is a strong arm of Home Care Path (www.homecarepath.com) a community based organization committed to performing a service that supports the changing needs of an aging population.  You are cordially invited to download your free PATH ALONG App today, seniors are saying they would not go to the hospital without their PATH ALONG app

http://appsmakerstore.com/appim/j6kcdet8xvwk4s