Post Acute Care: Site Optimization
Simplify the Journey from Hospital to Home
The journey from hospital to home can be complex and often highly fragmented. A simplified path home should include discharge plans that identify the right provider and address the whole person, including:
- Non-clinical support
- Effective member engagement
- Coordinated care
- Provider communication and engagement
We connect members to the follow-up care they need—both clinical and non-clinical—to improve outcomes and experiences while reducing readmissions.

Our Approach
Our Site Optimization solution ensures that members who can safely go home after a hospital stay, do go home with the right services. For members who require a transition to a post-acute care facility, we identify the right provider and proactively engage facilities to ensure optimal length of stay and recovery plan progress for the duration of their stay.
The journey home from the hospital begins with our HomeFirst Analytics and clinical engagement teams. Alongside our analytics, clinical engagement teams collaborate with providers and advocate for members. They work with the hospital to understand the member’s clinical and non-clinical needs and ensure the right home services are in place. By doing so, we set members up for success in meeting their care goals and reduce the number of unnecessary post-acute stays and unnecessary readmissions.
For members appropriate to transition to a PAC facility, we engage on day one to ensure facility alignment with outcome goals and establish measurable milestones. By doing so, we can optimize the length of stay and ensure appropriate discharge home.
Program Results
PMPM in Annual Savings1
States with Clinical Support Teams1
Reduction in Total SNF Days2
Of Members Prefer Receiving Care in the Home3

The CareCentrix Value
With the appropriate support, coordination, and real-time data, CareCentrix can reduce unnecessary PAC stays and increase positive outcomes for members who follow our discharge recommendations.
Our Site Optimization solution leverages HomeBridge®, our proprietary care coordination platform, which provides a single platform to document and access information offering complete transparency for providers and the care teams to manage hospital discharge. Our platform seamlessly integrates with health plans’ systems and includes automated data feeds, clinical notes, and authorizations to manage care effectively.
CareCentrix has a robust implementation process that begins with a dedicated and experienced team, focused on flawless execution to get the Site Optimization program up and running.
Ready to optimize SNF utilization and improve member experience?
We’re here to answer any questions you have and discuss how we can help you optimize the transition of care home for your members.
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