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AmeriHealth New Jersey offers a Hospital Readmission Prevention Program
that targets members who have
a primary or secondary diagnosis of heart failure (HF) or have conditions that
increase their risk of developing
symptoms of HF. The program helps patients learn self-care and aims to remove
barriers to care. The ultimate goal
of the program is to reduce avoidable hospitalizations and unnecessary
utilization of both the emergency room/department (ER) and observation
services.
Based on our predictive model that includes clinical and sociodemographic
risk factors and medication history, we are able to identify members who are
likely to be readmitted to the hospital.
AmeriHealth New Jersey is working with ReAdmission Solutions, LLC (RAS), a
specialized company with a proven track record in patient navigation, care
coordination, and remote monitoring technology. RAS will work with providers
and their AmeriHealth New Jersey patients on a multi-faceted advanced disease
management program that includes the following key components:
- scheduling and coordinating appointments and facilitating transportation
through community resources, if available;
- continuous remote monitoring using advanced technology;
- home visits in accordance with the patient's home health benefit plan.
In addition, a RAS clinical coordinator is available 24 hours a day, 7 days a
week to answer questions for both patients and doctors. During their inpatient
stay, clinical coordinators may also be available to assist patients who have
been admitted to the hospital.
If you would like to refer a patient to the program, please contact RAS
directly at 1-800-533-3755. If you have questions or suggestions about
the program, please contact your network medical director.
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