MVP Health Care Embeds RNs at Rochester Regional to Improve Transitions

A recent study from the Joint Commission Journal on Quality and Patient Safety found that only between 50 and 60 percent of patients remember key information from recent inpatient stays, and only 50 percent correctly recalled post-discharge treatment plans. To address this problem, Rochester Regional Health in New York is partnering with MVP Health Care, a nonprofit health insurer in New York and Vermont, to launch a care management and engagement program to better serve patients in the hospital and in their transition post-discharge.

Through the program, MVP registered nurses will work on-site at nine-hospital Rochester Regional Health as care managers, providing wrap-around health care services to MVP customers during their hospital stay and post-discharge. Embedding care managers in the hospital provides patients with additional opportunities to ask questions and more deeply understand their care plan and benefit options, ensuring they have the resources needed to achieve the best health outcomes, MVP said.

The services offered by on-site care managers will include:

• Facilitating post-discharge follow up with appropriate providers.
• Ensuring that customers understand their MVP benefits.
• Additional support with regard to medication management.
• Evaluating social determinants of health impacts to each customer and their care plan, such as coordinating transportation assistance and meal delivery options.
• Providing appropriate referrals and support for customers that may not have a relationship with specific doctors for follow-up.

\“We are thrilled to be partnering with MVP on this important initiative which will better serve our patients and families,” said Rochester General Hospital President and Chief Operating Officer Tammy Snyder in a statement. “This enhanced support will ensure that our patients are well positioned to continue to heal and thrive outside of our hospital setting as well as minimize the risk for readmission.”

 “Sometimes customers don’t know what questions to ask in the hospital,” said MVP Leader of Case Management Operations Charlene Schlude in a statement. “Sometimes they’re so focused on the reason they’re in the hospital that they forget to consider the health and social needs they may experience at home. This new care management program is an exciting opportunity for MVP to have a greater impact on the health of customers by ensuring they fully understand their care plan and the benefits to support it.”

Earlier this year, Healthcare Innovation described an effort by MVP Health Care to take better advantage of paramedics to provide care to patients at home or at work.

The Treatment in Place program is activated when an MVP member calls 911, and an EMS provider is dispatched to the member’s location. Through the program, EMTs and paramedics in partner organizations now have access to a team from UCM Digital Health, including their medical staff and team of care coordinators, to better enable treating the patient in their location. EMTs or paramedics then work with a UCM emergency medicine-trained physician via telemedicine to quickly treat patients with non-life-threatening conditions.