Physicians Organization embracing care management as team approach continues to shape the future of primary care

MNOHS logo 7-1-2013

Focus on admissions, discharge and transitions also guides move toward team care

Media Contact: Barbara Fornasiero, EAFocus Communications, 248-260-8466, barbara@eafocus.com

Rochester, Mich. – March 11, 2015 –MedNetOne Health Solutions (MNOHS), a Michigan-based healthcare management organization serving the infrastructure and clinical support needs of private practice physicians and behavioral health specialists, is expanding its care management services as team-based care continues to shape the future of primary care. Maureen Murphy, FNP- BC, Director of Clinical Affairs for MNOHS, said her organization has been building the PO’s team capabilities since 2006, when it launched what was then called the chronic care travel team.

“Long before the advent of mandated health reform, progressive POs could see that physician members needed to use more of a clinical team-based approach to care for patients with multiple chronic conditions such as diabetes, obesity and hypertension,” Murphy said. “We are finding that team based care, typically including the skills of a nurse, dietitian, and behavior health specialist, has been a logical driver to care management, whereby a patient’s care is coordinated by a care manager who serves a specific patient population.”

Care managers, often nurses, work with individuals to identify their goals and locate the specific medical and psycho-social services needed for comprehensive patient care. Murphy says her PO’s physician members, as well as insurance providers, are increasingly seeing the value in care managers.

“Primary care physicians are sold on the quality of team based care to treat complex patients holistically. They see the benefit to patients when care managers closely aligned with the physician’s practice not only provide direct care but coordinate care with area community service agencies to meet the psycho-social needs of patients that are beyond the scope of the primary care physician’s office,” Murphy said. “Similarly, payors are seeing the benefit of care managers because of decreased emergency department utilization and the frequency of readmissions by medically complex patients.”

Care management is especially important to payors when it comes to the elderly population and hospital admissions, discharges and transitions (ADT) of care to home, nursing homes or rehab facilities as patient conditions and care needs change. According to the Centers for Medicare and Medicaid Services (CMS), approximately 2.6 million seniors are readmitted to a hospital within 30 days of their discharge at a cost of over $26 billion annually. Yet, almost three-quarters of those readmissions—representing an estimated $12 -$17 billion in Medicare spending—have shown to be potentially avoidable, a Medicare Payment Advisory Commission (MedPAC) analysis found.

“Medicare, Medicaid and other payors need to rein in costs by keeping patients healthy and out of the hospital readmission cycle,” Murphy said. “Care managers can be the solution in many of these cases and are even more effective when part of the admissions process up front when patients and caregivers have an opportunity for enrollment in care management services. This is particularly beneficial with an acute care event, especially with patients in the vulnerable 30 days post-discharge timeline.”

In response to the growing emphasis on ADT, MNOHS CEO Ewa Matuszewski says her organization is building up its care management and training and education services.

“MNOHS historically has had a strong training focus because we’ve found training to be a key differentiator in the services we provide our physician and care team members. As the administration of healthcare becomes more demanding, so does the need for regular, competency-based training for physicians and their practice teams; that’s why we continue to invest in our training capabilities,” Matuszewski said. “Our approach to care management is similar, because payors are seeing the benefits of using care managers to monitor patient care quality and reduce costs for specific patient populations throughout the ADT process. That’s right in our wheelhouse at MNOHS and we’re aggressively pursuing these opportunities and finding success.”

About MedNetOne Health Solutions:
MedNetOne Health Solutions (MNOHS), a leader in advancing the development and implementation of the Patient-Centered Medial Home (PCMH), is a health care management organization for primary and specialty care physicians and behavioral health specialists that provides administrative infrastructure and clinical support and programming to develop and sustain high performing, patient-centric practices while meeting government healthcare reform mandates. Learn more at http://www.mednetone.net.

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