Seniors and those who are sick or in recovery from COVID-19 avoid crowded public spaces. That leads to isolation and a new set of issues, especially among the ill. In response, Southwestern Health Resources has teamed up with Encompass Home Health to deliver care packages to elderly patients who are quarantined at home after being diagnosed with COVID-19.
The care packages included items that are difficult to find in stores, such as toilet paper, paper towels, hand sanitizer, protein drinks, and soap. In addition the organizations are managing the care of those patients with more frequent check-in calls and home health visits.
The majority of SWHR’s 900 employees are on what the organization calls its reimagining care team, which manages cases, referrals, best practices, and utilization on behalf of payers to keep quality high and cost low. There are around 5,000 providers in the network that cover about 750,000 lives in DFW.
The services extend beyond a care package, though. With more people avoiding the hospital because of COVID-19, telehealth and case management become even more important to make sure people are getting the care they need and not delaying a doctor visit or trip to the hospital. The organization uses its troves of data to identify at risk patients who may need more frequent contact, including those recovering from COVID-19. “For us, this is ultimately about keeping people safe,” says Dr. Sanjay Doddamani, the chief physician executive at SWHR.
The frequent contact helps the staff build relationships with patients, which improves mental health needs for isolated seniors, but also helps staff diagnose potential future obstacles. The care package delivery can also facilitate a conversation about the follow up care after a patient leaves the hospital for COVID-19. “We are impacting patients and making sure we contact them and develop relationships in our care management program,” says Yolanda Rodriguez, vice president of care and disease management.
“We find ourselves in an important triad between patient, provider, and population management, where the physician is driving the care,” says Doddamani. Sometimes care management contact is initiated by SWHR, while other times the patient’s physician can request that the patient receives follow up. It is all part of maintaining a high level of care and avoiding costly and unnecessary trips to the hospital, which drive up healthcare costs overall.
“We are an extension of the provider, and we present ourselves in that manner to focus on relationship building,” Rodriguez says “The member is at the center, and we work in concert with members and their families.”