Discharge Planning/Care Coordination Performance Improvement

Quality Healthcare Partners (Quality) offers executive consulting services to organizations that are interested in improving their care management, transitions of care and outpatient care coordination. Healthcare systems are changing the way they are aligning with payers. Care management is much more than traditional discharge planning, social worker placement or outpatient embedded case management programs. It involves implementing clinical practice protocols, coordinating post care discharge, population health management, transition of care, and navigator protocols managing 90-day episodes of care programs at the point of patient access. Longitudinal care plans are the next wave of care management.

Who Should Consider Consultative Services in These Areas?

  • Hospital Case Management Programs
  • Accountable care organizations (ACOs)
  • Care Coordination Programs
  • University Hospitals
  • Community Health Centers
  • Staff Model Health Plans
  • Physician Clinically Integrated Networks
  • Hospital Systems
  • Clinical Integrated Networks
  • Centralized Clinical Health Call Centers
  • Post-Acute Programs
  • Physician Hospital Organizations
  • Navigator Programs
  • Wellness and Chronic Disease Programs

Our Experience and Service Offerings

Quality’s executive team’s credentials include actual work experience developing case management and care management programs aligned with finance and clinical integration. As part of our services, we provide a comprehensive needs assessment and develop detailed action plans to build a more cohesive Care Management and Transitions of Care Department. Quality consulting services will jump start your organizational operations to effectively respond to the demands of decreasing avoidable readmissions, bundled payment management, and effective out-patient care coordination.

What we offer as part of our Care Management/Transitions of Care Improvement and Interim Staffing Services

Quality’s experts will assist your organization with a needs assessment and Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis. We will perform these assessments onsite, and provide you with a detailed report.

Our Care Management/Transitions of Care Improvement Services will observe your operations and identify opportunities for improvement to include:

  • Assess your organizational structure and leadership
  • Appraise the effectiveness of the workflow and processes of the care management program
  • Review care management models best for your setting
  • Identify barriers to the progress of care and solutions
  • Review your population health analytical tools and criteria for identifying at-risk consumers
  • Identify recommended tools and education needs of care management staff
  • Review program descriptions, consumer access and availability and follow through by staff
  • Evaluate performance measurement and reporting
  • Review orthopedic, neurosurgical and surgical spends
  • Assess the effectiveness of your transition of care action plan and identify opportunities to improve outcomes
  • Review your current readmission initiatives and provide recommendations for a future state

Clinically Focused Care Management and Transitions of Care Action Planning

It has never been more critical for the future success and financial stability of health care organizations to invest in a third-party evaluation of their Care Management and Transition of Care Programs to ensure sustainable clinically focused results are achieved both in the inpatient and outpatient settings. Fragmented care coordination and gaps in transition of care represents loses in revenue through increased readmission rates, delays in care, longer length of stay and poor health outcomes for patients with chronic conditions.

As part of our service offering, Quality provides these additional services:

  • On-Site Model Implementation Support
  • Education and Training
  • Future Design Care Management Model Development
  • Interim Hospital Care Management Director Support
  • Interim ACO Care Management Director Support
  • Interim Transition of Care Director Support
  • Interim Health Plan Case Management Director Support
  • Interim Hospital CM Director/Manager Support
  • Interim Clinical Integration Operations Director Support
  • Interim Medicaid Community Outreach Director/Manager Support
  • Interim Patient Financial Services Director Support
  • Interim IT Support with Epic, Oracle Health/Cerner, Meditech
  • Interim CFO Support
  • Interim ACO Population Health Director Support
  • Interim Emergency Room Social Work/UR Program support

Benefits to your Organization

  • Avoid painful, expensive mistakes, problems and surprises
  • Improve organizational efficiency and productivity tailored to your organization
  • Learn from others who have successfully transformed Care Management and Transitions of Care Departments
  • Address organizational and resource concerns by bringing objective and experienced expertise to work side-by-side with your people
  • Implement process changes that meet your business goals