Innovation Health - Care Management Video Transcript

Innovation Health: The evolution of care in Northern Virginia

What's different about Innovation Health?

David Notari, Cheif Executive Officer, Innovation Health: Innovation Health is transforming the way we deliver health care here in this marketplace.

Mary Worth, Enhanced Care Coordinator-Manager, Inova/Innovation Health: You have doctors, facilities, hospital facilities, and payers coming together to give excellent quality care at a lower cost.

Kimberly Bulter, Enhanced Care Coordinator, Inova: It’s a natural thing. I don’t know why it wasn't done earlier in the health care world. But that’s what makes it unique.

Collaboration counts

Jennifer Kelly, Clinical Health Services Supervisor, Aetna: What makes Innovation Health different is our Enhanced Care Coordinators. They are nurses who identify members for earlier outreach from a case manager, to provide that member with the services and resources they need.

Enhanced care coordinator model

Our unique Enhanced Care Coordinator model means we focus our daily work on finding and addressing problems early.

1. Review patient census daily: Each day, we review the charts of members who are in the hospital.

2. Review each member's medical and claims history: We add that data to the member’s clinical records, claims records and things like health assessments to get a complete picture of the member’s overall health.

3. Engage the member in a treatment plan: Together, our on‐site Enhanced Care Coordinators and their Aetna counterparts create coordinated care plans to help members make a smooth transition between hospital and home and manage their chronic conditions.

4. Monitor results and follow up: We work one‐on‐one with members to ensure they are following their care plan.

5. Coordinate care plan with Aetna and Inova resources: Innovation Health members have access to a comprehensive array of resources from both Aetna and Inova.

The Aetna-Inova Collaboration

The collaboration between Aetna and Inova truly improves the member experience.

Find patient and population trends: We share integrated claims and clinical data, which lets us work together as one care team.

Engage more patients earlier: We identify trends that let us reach out to patients, often before they are sick, to engage them in our programs and services – and keep them healthier.

Help providers achieve better outcomes: We incent health care providers to achieve better outcomes with rewards that are based on the quality and efficiency of their care, not the volume of services they provide.

Reaching patients early

David Notari: Typical insurance companies don’t know they have patients in the hospital until the claim hits the system, and then they can start to engage that patient. We’re actually able to engage patients at the point of care.

Improved member engagement through preferred channels

Innovation Health members have an array of tools and technology available to them.

A broad care team: A team focused on keeping them healthy.

24/7 access: 24/7 remote access to a care nurse and secure patient medical records.

Mobile apps: Mobile apps that help them find the right care and manage their health.

Health reminders: Reminders to support a healthy lifestyle and monitor their progress on health goals.

Care alerts: Alerts to remind them if they’ve missed a screening test or filling a prescription.

Improving care quality and cost: Our goal is to improve the care experience by helping members stay healthy, navigate the system and understand costs.

David Notari: We can avoid unnecessary visits to the emergency room, we can avoid unnecessary readmissions into the hospital if we have a caregiver that’s following that patient.

The importance of primary care

Kimberly Butler: A lot of people think they don’t need a primary care provider, but it’s good to have somebody who knows you. You want to establish a relationship.

Mary Worth - Finding a provider that fits: We can provide physicians in their area, near their home, near their work, with a language that they need.

Timely decisions enabled by technology

Mary Worth: This is the beautiful, unique thing about Innovation Health – we have access to the patients’ charts in real time, at the point of care, at the point of service.

David Notari: We’re able to take that information, identify gaps in care and be able to interact with the patient face to face.

Kimberly Butler: Information is at our fingertips where we can make decisions in a more timely manner. It’s right now.

Mary Worth: All the providers are aware of what’s happening with the patient and the patient has a better sense that people know what’s going on because we do.

Transforming lives

David Notari: At the end of the day, better care equals better quality equals better cost.

Kimberly Butler: I have the opportunity to transform lives, one member at a time. It works.