Health Alliance Medical Plans and naviHealth announced today the expansion of a partnership to prevent costly hospital readmissions. 

The partnership will utilize naviHealth’s clinical decision support technology and field-based Care Managers to manage Health Alliance’s members across the post-acute care continuum, the company said in a release.

“As greater coordination of care is increasingly being recognized as a key driver of improved outcomes and cost savings, this type of comprehensive partnership simply makes sense and has the potential to be extremely valuable for all stakeholders involved,” said naviHealth President Clay Richards. 

naviHealth has been managing post-acute care in the skilled nursing setting for Health Alliance since 2010. Under the expanded program, naviHealth aims to engage patients and care teams starting in the hospital to understand efficient options for rehabilitation and skilled nursing services. 

naviHealth’s Care Managers work with patients, caregivers and providers to establish personalized rehabilitation goals and measure progress towards these goals until a patient has successfully transitioned back to the community.

naviHealth uses evidence-based protocols and technology-enabled services to optimize care and align all stakeholders. With over 12 years of experience managing post-acute care, naviHealth currently serves over one million Medicare beneficiaries in 15 states.

“Health Alliance is pleased to offer this range of expanded post-acute services, to help our members get the right care in the right setting,” said Dr. Robert Parker, Health Alliance chief medical officer. 

Health Alliance is a provider-sponsored health plan in the Midwest, administering health plans for nearly 300,000 people in Iowa and Illinois. 

From 2006-2011, Medicare spending on post-acute care increased 46% to $63.5 billion, according to statistics from A Data Book: Health care spending and the Medicare program.

Initiatives to improve the efficiency and outcomes of post-acute care continue to gain momentum, especially as hospitals face increasing reimbursement penalties for high readmission rates from the Centers for Medicare & Medicaid Services. 

This expanded risk-based management services agreement will go into effect May 1, 2013. 

Written by Jason Oliva