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Help your heart failure patients avoid hospital readmission

May 1, 2015

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Independence 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.

Independence is working with ReAdmission Solutions, LLC (RAS), an independent, specialized company with a proven track record in patient navigation, care coordination, and remote monitoring technology. RAS will work with providers and their Independence 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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Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association, serving the health insurance needs of Philadelphia and southeastern Pennsylvania.