OCTOBER 2012
IN THIS ISSUE
  Introducing HealthEssentials EPO: A Low-Cost Alternative for Small Groups
  New Underwriting Guidelines for Small Groups
Serving Your Clients in Their Neighborhoods
  Better Outcomes, Reduced Costs
We Have Big Plans for Western NY
New Program Lowers Hospital Readmissions, Reduces Costs

New Program Lowers Hospital Readmissions, Reduces Costs

At EmblemHealth, we're striving to reduce costs so you can provide your clients with more value for their health care dollars. Results from a recent study published in the American Journal of Managed Care showed that an EmblemHealth pilot program to provide care after hospitalization significantly reduced the 30-day readmission rate per member by almost 37 percent and the total number of hospitalized days by 43 percent.

In this study, a dedicated treatment team was integrated into a large, urban medical group to provide transitional care to our members after their hospital stays. The team, which included a nurse, social worker, pharmacist and two point-of-care "navigators," identified barriers to treatment or medication adherence and worked with members to overcome those barriers.

Lead investigator Dr. Andrew Kolbasovsky stated, "By locating this diverse clinical team at the point of care — in the offices of a medical group — we were able to significantly reduce hospital 30-day hospital readmissions and their associated costs. The savings we realized were more than sufficient to cover the costs of the program."

For details on this pilot program, we encourage you to read the study.

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