Coordinating personal care and home health at scale
The home care industry is undergoing transformative change as others in the healthcare ecosystem – from CMS to health insurers, hospitals, MCOs and the seniors and families we serve – recognize the impact of non-medical factors on health outcomes and quality of life.
The healthcare industry now recognizes that functional limitations1 and social determinants2 related to health outcomes drive a multiple of cost for complex chronic populations. For patients 65 and older with 3 or more chronic conditions, the traditional healthcare system isn’t designed to manage the challenges of patients with functional limitations and social determinants.
The Amedisys Care Coordination Program brings together home healthcare and personal care, via interoperable technology at national scale, to deliver coordinated care for patients who have both clinical and non-clinical needs. This interoperability helps ensure better coordination between Amedisys' home healthcare providers and personal care agencies, particularly with activities of daily living, to help keep clients out of the hospital, and safe and well in their homes.
How the Amedisys Care Coordination Program Works
Amedisys has chosen ClearCare as its technology system partner to deliver the interoperability that connects Amedisys to personal care agency partners at a national scale. Participating personal care agencies coordinate care directly with Amedisys through the ClearCare platform to deliver care at new levels of quality and service. There are two primary methods for coordinating care through this program:
Agencies can also send care requests to Amedisys
After obtaining patient's consent, your agency will be able to electronically submit care requests directly to Amedisys, through ClearCare, for your personal care clients who have clinical care needs.
You will be able to provide better care and coordinated care transitions in the event of a hospitalization or other acute episodes. The Amedisys Care Coordination Program will keep your patients out of acute settings and help ensure seamless transitions to home.
Since Care Requests are based on the patient need determined by the Amedisys Care Navigator team, there is no guarantee of number of leads or consistency of requests. The number of Care Requests a participating agency can expect to receive will vary by geography. More densely populated areas and areas where Amedisys’ presence is the strongest are likely to have more patients who require personal care.
ClearCare will not send existing clients from Amedisys to your agency or to any other agency on ClearCare. We run a deduplication process before passing along the Care Request from Amedisys to enrolled agencies.
If a duplicate is identified, Amedisys is notified so that they can in turn notify the client. The client will be directed to talk to their home care agency in order to enroll (versus enrolling via Amedisys).
Duration of care will vary by patient. Patients who come through without an authorization can be engaged by your agency like any other prospective client to determine appropriate care. Care Requests that include an authorization will contain details of care requirements and parameters.
The Amedisys Care Coordination Program is available to agencies using the ClearCare platform who complete the prerequisites. A contract addendum is required.
If you are a new ClearCare agency, we'll discuss the Care Coordination Program enrollment process at the time you sign a ClearCare contract.
No. Care Requests go to the first enrolled agency to accept the request.
Your agency staff will be required to watch a training video to finalize your enrollment. This training must be completed before your agency can receive or send Care Requests.
The Care Coordination with Amedisys Program allows you to leverage the Amedisys brand, so for compliance and other reasons, this training is required and is designed to help you maximize the program with clients and referral sources.
As Amedisys rolls out new programs – for instance with health plans and ACOs – there may be additional requirements to participate that are specific to those programs. In some of these programs, Amedisys or the health plan will be sending over new clients, and paying for the work.
Enrollment in Amedisys Care Coordination Program is available now for ClearCare agency partners.
1 e.g. a disability, or does not have the physical, cognitive or psychological ability to independently perform the routine activities of daily living – such as dementia
2 e.g. physical and geographical living conditions, economic status and access to healthcare