For Health Plans
The healthcare profession and the insurance industry have long sought an optimal balance between patient quality of life and healthcare costs. There is growing consensus that the best way to achieve this is by providing high quality, personalized medical care to those patients who have the most complex healthcare challenges.
While CMS and private insurance providers implement responsible treatment and reimbursement strategies, hospitals and nursing homes face growing challenges. Nearly three-fourths of adult patients hospitalized in America suffer from multiple chronic conditions. The number of people living in long-term nursing facilities in the US is expected to double to more than 3 million by 2030, while more than 40% of adults will die there.
Personal Care Medical Associates (PCMA) can help
The Center to Advance Palliative Care found that only 5% of patients accounted for a staggering 60% of healthcare costs in 2011. For several years, PCMA has provided customized, physician-led geriatric and palliative services to patients with the most challenging medical conditions.
Services for Payers
PCMA’s palliative, geriatric, and transitional care services will increase the efficiency of healthcare services provided to insured patients. Services include:
- Customized evaluation and treatment planning of complex curable, chronic, or life-limiting medical conditions
- Relief and prevention of suffering of patients of any age and at any stage of complex medical conditions
- High-quality continuum of care, including comprehensive discharge summaries, which become vitally important as patients move among emergency departments, inpatient hospitalization, skilled nursing facilities, assisted living facilities, rehab facilities, hospice, and their own homes
- Staff training for nursing facilities
- Patient and family education
- Electronic Health Record (EHR) specifically designed for the geriatrics, which supports and improves our goals for quality of care
- PCMA has a full time consultant pharmacist on staff to assist clinicians with prescribing, and more importantly deprescribing medications. We recognize that polypharmacy has become such a clinical and economic burden to patients and physicians, and hope to improve the pharmacologic treatment of our patients.
PCMA’s unique services can benefit insurers in several ways:
- Increased patient and family comfort and satisfaction
- Improved clinical and quality of care outcomes, reduced pain and other troubling symptoms, and improved patients’ quality of life
- When provided in a skilled nursing facility, reduced diagnostic and treatment interventions, duration of stays, and number of in-hospital deaths
- Cost savings and enhanced reputation through responsible and efficient reimbursements
- Work with all parties to improve duration of care and services
- Emphasis on proper medication prescribing in the elderly