Care Transitions Registration and Exchange Navigators

Hospital readmissions are no longer an acceptable piece of the health care delivery system.  Medicare and Medicaid (CMS) have established regulatory policy that moves hospital providers toward interventions to reduce readmission rates.  Health care planners have embraced the idea of paying closer attention to care transitions as an effective way to manage hospital readmissions.

In Wisconsin the comprehensive PATH ALONG model is being utilized throughout the community.  The Wisconsin PATH ALONG model gives an easily understood structure to the multiple , varied care transitions associated with a hospital stay.

Registration is listed as a care transition.  On the coaching sheet this care transition looks like:

Hospital registration     (transition)     Clinic registration

Dynamic component- Valid medical pay sources, formulary constraints

Rationale: knowledge of payment informs choice and prevents a rehospitalization

When you sign in at the registration desk prior to admission you are authorizing the hospital claims department to bill you and your pay sources for the service that is provided.  This is where you want to encourage the prescribing providers to order medications and treatments that can be (Covered) paid for through your insurance plans.

Each health insurance policy will have a list (formulary) of the covered medications.  Having the hospital staff prescribe from the list of covered medications will save you money when you go to the home town pharmacy to fill the MD order.  Consumers are more likely to take their medication knowing the pills are covered, and there is less out of pocket payment required.

During the hospital registration process people in between health insurance plans (without coverage) can request additional assistance.  Additional assistance is the help of another in determining which potential pay sources could contribute to your much needed health bills. 

The Federal Government has provided grant funding to establish exchange navigators in the State of Wisconsin who can assist families with finding a valid medical pay source.  This pushes instructional resources out in to the local counties to help families eligible for the various private and public health insurance plans get the much needed access. 

The community health care providers benefit from this effort by knowing the service will be paid for.  Families can better understand how a combination of public and private pay sources can be made available for continued health care needs.  The consumer is encouraged to provide both the hospital registration department and the community clinic registration department with the same information.  Up to date information insures the benefits through your valid pay sources will be exhausted before the medical provider turns to out of pocket payment.

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

http://appsmakerstore.com/appim/j6kcdet8xvwk4s

Home Care Path (www.homecarepath.com) received a Healthy Community Partnership Grant from St. Clare Health Care Foundation to demonstrate how attention to care transitions can keep families from having to run back and forth to the hospital.  This is a free event and everyone is invited to attend.  This includes Pizza from 2 Brother's Pizza and Buffet 221 Broadway Wisconsin Dells  https://www.facebook.com/2BrothersPizzaBuffet

Date and Location of free presentation to simplify care transitions

 Monday August 19, 2013 - 1 pm
Baraboo Senior Center (Civic Center)
124 Second Street, Baraboo WI 53913

          PLEASE  PLAN  TO  ATTEND!!!