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Community Health Network's discovery that 43 percent of its heart failure readmissions were driven by patients discharged home alone to self-care has led Community to risk-stratify all patients while in the hospital and visit their high-risk population at home.
Community and Central Maine Medical Center are two examples of healthcare organizations visiting medically complex patients at high risk of readmission in their homes, leveraging existing expertise and in some cases partnering with home health to include the patient's home in the care continuum.
New Horizons in Healthcare Home Visits profiles these two home visit interventions that are helping to reduce hospital readmissions and emergency room visits, while enhancing the patient experience.
HIN's 2013 Home Visits market survey found that 75 percent of respondents visit some percentage of patients or health plan members at home.
This 30-page special report examines the following programs:
In an interview with Lisa Collins, RN, MSN, chief clinical and operations officer of Community Home Health Services, and Deborah Lyons, network disease management executive director, the following aspects of Community Health Network's home visit program are discussed:
Ms. Horton also covers the following program aspects: