Health Plans often pay a large price for excess readmissions. Health Plans are concerned about all readmissions not just the 30 day readmissions. While 20% of Medicare patients are readmitted within 30 days, 34% are readmitted within 90 days. Maxlink Health's TeleHealth Readmission Reduction Program (RRP) provides health plans with both 30 & 90 day programs. Maxlink Health will partner with health plans and work with existing case management, utilization management staff to ensure a guaranteed reduction and avoidance of readmissions.
At Maxlink Health we use a proven care system in which the RN Care Coordinator takes the hospital patient discharge orders and proactively coordinates care with patient's primary care provider and other community health providers. All patients are remotely monitored by our global nursing call center.
Through a combination of pre-discharge and post discharge procedures, Maxlink Health TeleHealth has created a program that will reduce the amount of hospital readmissions.
Care Transition Planning: converting discharge orders to care transition plans, medication reconciliation, care coordination, patient education and scheduling PCP follow up.
Proactive Patient Centric Care Coordination: This step is crucial because it executes the care transition plan, ensures physicians are aware of their patients' health status, while providing medication compliance & patient education.
Remote TeleHealth Monitoring: allows us to track daily health status and vitals with the patient in addition to tracking symptoms and potential side effects to medications
At Maxlink Health we are aware that the highest risk for readmission happens within first 45 days of patient discharge. The best discharge plans begin to unravel once the patient gets home. Maxlink Health TeleHealth continues the care with our Readmission Reduction Program and will prove the guaranteed benefit over time.