Health technology continues to advance and the healthcare industry continues to develop new and more effective methods of providing the appropriate medical care for those injured in an auto no-fault or workers’ compensation accident. With the multitude of healthcare providers and these numerous advances in medical care and medical devices, it can be incredibly challenging for an insurance carrier to stay informed on the best methods for indemnifying claimants and authorizing the most cost-effective and appropriate medical care for them. When an auto no-fault or workers’ comp accident occurs and the claimant has been hospitalized for minor or catastrophic injuries, home health care services are frequently ordered as an appropriate method of continued medical care for some claimants.
According to the Institute for Healthcare Improvement, up to 33 percent of American healthcare expenditures involve hospitalizations, and a recentarticle by Robert Herzog published on HIT Consultant’s website suggests that 19 percent of this total involves hospital readmissions occurring within one month of the original hospital discharge date. Herzog estimates that 75 percent of readmissions for patients on Medicare could have been avoided, and that these situations may account for up to $12 billion in additional Medicare costs. Furthermore, 20 percent of the patients referred to in Herzog’s article experienced a harmful medical incident one month or less from their discharge date.
While this particular study pertained mostly to Medicare-related hospital admissions, correlations can be drawn from it that are also highly relevant to auto no-fault and workers’ comp claims involving claimant hospitalization and the use of home health care services to help prevent hospital readmission. Claimants discharged from a hospital stay related to an auto no-fault or workers’ comp accident oftentimes may need follow-up medical care. In claims involving more catastrophic injuries where the claimant may be unable to leave their home without extensive assistance, home health care services may be a cost saving option for the insurance carrier. The article by Herzog reports that fewer than 50 percent of discharged patients see a doctor after the discharge and before a readmission event, and individuals who live by themselves are more likely to require hospital readmission. When a home health care professional is able to provide follow-up medical care to a claimant in their own home, it provides an effective way to ensure the claimant is following the prescribed medical treatment. The use of home health care may then help to reduce hospital readmission rates for claimants and reduce claim costs for insurance carriers.
By partnering with an organization such as Northwood, an insurance carrier will ensure that their claimants have access to home health care services, when appropriate. Northwood’s network of credentialed home health care providers is accessible to the insurance carrier and its adjusters/examiners, providing ways to reduce costs associated with injury related claims. When an insurance carrier provides its claimants with home health care services, they not only reduce their claim-related costs but also contribute to claimant satisfaction. Claimants do not pay out of pocket for home health care services related to the claim, and they may experience a more favorable outcome when home health care is utilized. For more information about home health care services, please contact a representative from Northwood at 877-684-9276.
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