The Challenge

Manage the symptoms and stress for members with serious illness at home

Providing the right level of care for members with a serious illness requires specialized palliative expertise and focus on the whole-person, which includes addressing social determinants of health and providing support for caregivers. A study has shown that over 50% of members requiring palliative care do not have access to services to help manage their conditions.1

Earlier identification and engagement, with members who could benefit from palliative support, ensure holistic care plans are established based on individual goals and values, avoids unwanted non-beneficial and costly medical treatment, supports existing primary care providers, and the timely transition to hospice.

See how our whole-person serious illness care at home can return up to a 3:1 ROI

An independent peer-reviewed study conducted by the Journal of Palliative Medicine, evaluated the impact of our Serious Illness Care at Home model.

  • Returns up to a 3:1 ROI4
  • 20% reduction in total medical costs1
  • 33% reduction in hospitalizations1
  • 38% reduction in ICU admissions1
  • 35.5 day increase in median length of hospice1
  • 98% member satisfaction 3

Program Results

0 Reduction in Total Medical Costs3
0 Reduction in ICU Admissions3
0 Member Satisfaction4

Our Approach

Our Serious Illness Care at Home solution leverages a population health approach, blending compassionate care with technology to uncover, address, and monitor many of the unmet medical and social needs of seriously ill members.

The Serious Illness Care at Home solution includes:

  • Predictive analytics to identify those who could benefit from supportive care for serious illness earlier, offsetting the need for emergency care or preventable hospitalizations sooner.
  • Leverage evidence-based protocols that combine in-home and telehealth visits to continually assess and address each member’s needs.
  • Develop and manage a regional network of specially trained palliative nurses and social workers supported by a highly systemized clinical program and web-based platform.
  • Engage and support members and caregivers to align healthcare decisions with their personalized goals and values.
  • Coordinate timely interventions with existing care delivery systems and providers.
  • Provide condition-specific support, home safety education, advance care planning, and caregiver and community support.
  • Drive improvements in quality, utilization, and for payor, member and family.

The CareCentrix Value

Our Serious Illness Care at Home solution is designed to easily implement, scale and integrate into existing care delivery systems. We proactively identify, engage and support members and caregivers to remain independent in their homes and make health care decisions aligned with their goals and values.

Our capabilities support metrics tied directly to CMS Star ratings including quality of care, member and caregiver satisfaction, post-hospital medication reconciliation and utilization.

1. Based on actual program results  2. Journal of Palliative Medicine. 2010, Sept 22 9: 1075-1081  3. Based on member satisfaction data. 2021  4. Based on program evaluation results. 2021