1 / 13

Area Agency on Aging 1-B Barbra Link, Director of Care Transitions

Beyond Care Transitions Coaching: A Multiple Strategy Approach to Reducing Readmission to Hi-Risk Populations. Area Agency on Aging 1-B Barbra Link, Director of Care Transitions Blink@aaa1b.com or 248-262-9223 Tina Berry, manager of Care Transitions TBERRY@AAA1B.COM OR 248-263-1444.

zarifa
Download Presentation

Area Agency on Aging 1-B Barbra Link, Director of Care Transitions

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Beyond Care Transitions Coaching: A Multiple Strategy Approach to Reducing Readmission to Hi-Risk Populations Area Agency on Aging 1-B Barbra Link, Director of Care Transitions Blink@aaa1b.com or 248-262-9223 Tina Berry, manager of Care Transitions TBERRY@AAA1B.COM OR 248-263-1444 May 29, 2013

  2. Conflict of Interest Statement The representatives of the AAA 1B and their co-presenters have no conflict of interest to declare We do not have any relevant financial relationships with any commercial interests

  3. Presentation Objectives Identify multiple Coaching approaches that can be utilized to reduce hospital readmissions. 

  4. Area Agencies on Aging • Established in 1970s under federal Older Americans Act • National Network • Four primary functions • Allocation of long term care funding • Planning and coordination of community-based network of long term care services • Advocacy • Unbiased access to information and care services • AAA 1-B services 29% of Michigan’s 60+ population residing in Oakland, Macomb, Livingston, Monroe, St. Clair, and Washtenaw counties • Provision of Care Transitions utilizes our skill set in unbiased care and case management

  5. Care Transitions

  6. Care Transitions cont.

  7. Bottom Line Care Transitions is targeted to chronically ill re-admitters and fee for service Medicare beneficiaries, with interventions beginning in the hospital and following the patient home and to the skilled nursing facility for 30 days post discharge.

  8. SEMCCTP Five Strategy Intervention to Reduce Hospital Readmissions

  9. SEMCCTP Five Strategy Approach Program Status

  10. YTD Enrollment by StrategySEMCCTP

  11. Partnerships: Working with Beaumont-Troy Hospital CDM Program • Cultivating the relationship • Using results • Using participant stories • Working together for process improvement • One participant’s story

  12. Questions?

  13. Contact Information Area Agency on Aging 1-B Barbra Link, Director of Care Transitions Blink@aaa1b.com or 248-262-9223 Tina Berry, manager of Care Transitions TBERRY@AAA1B.COM OR 248-263-1444 Michael Scully, Care Transitions Coach mscully@aaa1b.com or 248-263-1454

More Related