Healthcare Technology Featured Article

December 05, 2013

Aetna-CareCentrix Partnership Cuts Down on Hospital Readmission Rates

CareCentrix, a company that manages home-based care benefits, has partnered with Aetna's commercial members in Florida. Through CareCentrix's HomeSTAR program, the two organizations cut Aetna member re-hospitalization rates by almost 20 percent.

The HomeSTAR program helps patients transition from the around-the-clock care they receive in hospitals to taking care of their own needs when they return home. When they leave the hospital, patients get more than a discharge notice and a wheelchair ride to the door. They receive in-home risk assessments, coaching and coordination with hospital staff from CareCentrix.

CareCentrix is actually based in Hartford, Conn. They developed the HomeSTAR program to meet several CMS objectives: to improve the patient experience, to improve population-wide health and to reduce per capita healthcare costs.

For example, hospital readmission sucks over $30 million out of the American health system every year. Commercial readmissions cost 37 percent more than Medicare readmissions, which gives private insurers like Aetna an incentive to cut costs.

In many cases, patients leave the hospital unequipped to manage their own care. Because of language barriers, cultural beliefs or lack of medical understanding, they may fail to adhere to medication regimens and fail to communicate with their doctors. Also, patients may not have family and friends to provide adequate support when they leave the hospital.

Sometimes, systemic problems can contribute to readmissions. For example, as patients step down from ICU to non-critical hospital care to rehabilitation center to home, paperwork slips through the cracks, and providers don't communicate effectively. Also, poor technology interoperability keeps electronic records from transitioning between providers.

By providing support and coordination during the transition home, programs like HomeSTAR can significantly reduce readmission rates.

"A care delivery system built on ensuring members have what they need when and where they need it helps individuals be their healthiest, which helps the entire health care community," said Aetna Florida market president Christopher Ciano.

Edited by Alisen Downey

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