Nurses also identify lifestyle issues during yearly kitchen table conversations
High-touch models of healthcare that connect senior members with the appropriate providers improve outcomes, especially for the most frail. By improving outcomes, Schenectady, N.Y.-based MVP Healthcare has reported a 3-to-1 return on its high-touch model.
MVP employs nurse practitioners who visit the homes of about 20% of the plans 85,000 Medicare Advantage members to conduct “kitchen table” health assessments each year. The hour-long assessments, which include a non-invasive physical exam at no additional cost to members, have resulted in lower medical expenditures and hospital admissions, and higher plan loyalty, according to a yearlong study comparing the experiences of 10,000 MVP Medicare Advantage members.
Patrick J. Glavney, MVP’s executive vice president of Medicare, says member engagement improves when patients are more relaxed and in a familiar setting. About 20% of Medicare Advantage members-those 75 and older-benefit most from a high-touch approach, he says.
“They need the one-on-one, and a lot of interaction, through home assessments or through telephonic counseling services,” Glavney says. “They need that interaction to stay on track with monitoring their health status.”
Such personal assessments also give nurses an opportunity to identify potential hazards in the home, such as loose area rugs that could cause a slip-and-fall accident or the lack of home maintenance that could cause too-warm or too-cool indoor climates, says Margaret A. Martin, director, Medicare operations for MVP.
The assessment does not replace the need for a member’s primary care provider, however. Members’ established PCPs receive an outcome report from the home visit.
MVP also works with providers to do a more involved assessment for those members who might be reluctant to have a nurse practitioner in their home or who meet certain criteria, such as being on mulitple medications.
The approach has won praise from MVP members, who like the personal care they feel they receive. It’s also an advantage for the plan’s bottom line-even though the plan has had to hire more staff to accommodate the high-touch methods, the program has provided a 3-to-1 return on investment.