Bravo Health is taking some innovative approaches to care coordination.
The Baltimore-based company, which provides Medicare Advantage insurance plans, is finding new ways to accommodate seniors and their growing needs with its Advanced Care Centers, state-of-the-art healthcare practices for Bravo Health members. With three locations, two in Philadelphia and one in downtown Baltimore, the centers act as a supplement to patients’ primary care provider and are designed to treat immediate and complex health issues.
“It’s an adjunct service; it doesn’t replace primary care,” says Susan Porretta, director of health services utilization management for Bravo Health.
Bravo Health programs support more than 100,000 Medicare Advantage members including Special Needs Plans in the Pennsylvania tri-state and Mid-Atlantic regions. All three Advanced Care Centers opened in 2010.
Porretta explains that the Advanced Care Centers have case managers and a robust interdisciplinary team that help treat a variety of illnesses and injuries – from immediate care issues like infection, dehydration, shortness of breath, high or low blood sugar due to diabetes, and injury to complex care issues like heart disease, arthritis, asthma and pulmonary disease.
“[The centers] help prevent readmissions and improve access to care,” Porretta says. Plus, they also provide preventive screenings and medication reconciliation to patients.
Patients don’t need an appointment to come to any of the centers for treatment. Copayment or coinsurance may be required, in accordance with patients’ Bravo Health benefit plan.
Boosting Care Coordination Efforts
Studies show that poorly coordinated care transitions can jeopardize patient safety and quality of care and can lead to rehospitalization. In this regard, care coordination is not only a means of improving patient outcomes and the quality of care but it can also lead to cost savings that result from fewer readmissions.
Porretta says that the Medicare population is at the highest risk for readmissions because of their age and comorbidities, so care coordination is even more important with this population.
To improve care coordination throughout its entire population, Bravo works to identify the root causes of readmissions. The company has its own nurses staffed in some of its high-volume, high-risk hospitals who meet with members face-to-face to discuss the post-discharge plan of care and help facilitate the discharge plan.
“Rather than duplicating efforts, we’re working with them on their hospital model and reaching as many patients as we can,” Porretta says.
For example, one of the hospitals Bravo Health works with is a major inner-city hospital that only has one heart failure coordinator for its entire patient base. To complement that hospital’s existing services, Bravo brings in its own resources to maximize its reach to members to plan for discharge and reinforce disease education.
Another initiative that Bravo Health is employing to improve care coordination is a physician engagement model called Physician Organized Delivery (POD) System, launched by Bravo’s parent company HealthSpring. The POD system is made up of groups of independent physicians that voluntarily come together to work toward common goals for managing the patient population that they serve.
With a focus on preventive care, many physicians that participate in the POD system are also part of the company’s pay-for-quality program that monetarily rewards following best practice preventive guidelines.
For patients, the POD system gives them more benefits that what they would receive under traditional Medicare. Plus, members receive coordinated care through a focused network of primary care physicians and specialists who have full access to patients’ health and prescription information.