How H2H Works
Health2Home is a health care organization offering a combination of evidence-based programs proven to reduce avoidable admissions and length of stays in chronically ill patients. H2H provides the support and infrastructure to place these protocols into practice using your health care team or any portion of our network of nurses certified in transitional care.
H2H focuses on customizing and implementing programs for hospitals, insurance payors and physician groups. These programs are designed to benefit hospitals, insurance payors and physician groups as well as improve overall patient care. They typically include training, decision support, inpatient programs, emergency department programs, outpatient programs and health monitoring via telephone.
Our comprehensive approach to patient care combines appropriate protocols with an emphasis on transitional care at every level. You retain complete control over every aspect of your operation.
The mission of H2H is to deliver quantifiable savings and improved patient satisfaction. Any of our programs, when implemented individually, can make significant improvements. With the right combination of programs, patient health care and revenue can increase dramatically.
Programs Include:
- “Transition Coach”
- During a 4-week program, patients with complex care needs and family caregivers receive specific tools and work with a “Transition Coach” to learn self-management skills that will ensure their needs are met during the transition from hospital to home. Documented net savings of $857 per enrolled patient.
- "Reengineering the Hospital Discharge Program"
- This program decreased hospital utilization (combined emergency department visits and readmissions) within 30 days of discharge by about 30%. This program begins on day one of admission and continues up to 4 days after discharge.
- Project BOOST "Better Outcomes for Older Adults" - Society of Hospital Medicine
- Offers best practice resources to reduce 30 day readmission rates for general medicine patients (with particular focus on older adults). Improves facility patient satisfaction scores, the institution’s H-CAHPS scores related to discharge, and the flow of information between hospital and outpatient physicians. Also ensures high-risk patients are identified and specific interventions are offered to mitigate their risks and improve patient and family education practices. Also encourages use of the "teach-back" process around risk specific issues.
- Iowa Chronic Care Consortium - IVR - Iowa Medicaid Demonstration
- The demonstration included 266 Iowa Medicaid members and was conducted initially for heart failure patients. It reduced hospital admissions by 24%, hospital bed days by 22% and saved nearly $3 million by reducing healthcare service utilization, compared to a $2 million increase for the matched cohort.
Program Features
- Certified Transitional Care
- Statewide Networks
- Evidence-Based Programs
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