Facility-Based Care Solution

Help ensure the right care at post-acute facilities

After a hospital stay, some of your members may need the extra support of a post-acute care facility. When they do, we help make sure they receive quality, medically necessary care and appropriate lengths of stay in settings like skilled nursing and inpatient rehabilitation facilities and long-term acute care hospitals.

Lines of business

•  Commercial
•  Medicare

curved lines graphic

Connect care throughout your members’ post-acute journey

We know care works better when it’s connected, no matter where your members are recovering. When they’re in post-acute facilities, our efficient technology connects their care providers to our clinical guidelines and integrates with your care management system.

Create a better care experience

The quality of care your members receive can vary from one facility to the next, putting their health at risk and increasing their lengths of stay. Our solution helps ground care in evidence, ensuring higher-quality, more consistent post-acute care regardless of the setting.

 

Make transitions safer

We help reduce risks that can occur among your members during care transitions. Our approach supports quality care and reduced readmissions while managing costs.

 

Create a better path toward home

For most members, the goal is to return home where they’re most comfortable. We support that goal by helping ensure quality care, carefully monitoring progress, and managing length of stay. Once their condition improves, we help safely optimize their transition home.

 

Inside our Facility-Based Care Solution

Members who recover from a hospital stay in post-acute facilities deserve a better experience. Our clinical expertise and technology platform combine to optimize and connect their care.

Clinical appropriateness review

Length-of-stay management

Transition-of-care coordination

Advanced analytics and reporting

Clinical appropriateness review
Length-of-stay management
Transition-of-care coordination
Advanced analytics and reporting

How our solution works

Request
Your providers submit requests to us online for post-acute care.

Review
Our automated platform reviews the requests in real time, assessing service management, discharge plans, and health plan case management referral opportunities.

Determine
Requests that meet clinical criteria are immediately approved. Our clinical reviewers, including physicians, nurses, social workers, and therapists, consult with your providers about any requests that don’t meet our clinical guidelines.

Facility transition
After approving or optimizing the request, we coordinate your member’s transition to the facility.

Care and monitoring
We stay in communication with your provider as they care for your member and monitor progress and evaluating requests for additional days when needed.

Home transition
When it’s safe for your member to return home, we manage that transition too. Our home-based care team is available to manage any additional clinical or social needs to ensure optimal care and recovery.

Synchronize
Request data is shared with your system(s) for claims, care management, and reporting purposes.


Ask us about our Facility-Based Care Solution

Health plan leaders, contact us to learn more about the possibilities and impact of our Facility-Based Care Solution.

Are you a health plan member?

If you’re a health plan member and have a question about your health plan, please call the member services number on the back of your health plan ID card.

Provider inquiries

For questions about a request or portal support: Call 1-844-411-9622 or contact our support team .

For questions about the provider network: Call 1-833-585-6262 or email our network team.