Post-Acute Care: Overview

eviCore’s Post-Acute Care solution provides a patient-centered approach that goes beyond standard utilization review and prior authorization processes to coordinate the post-acute recovery process.  We help patients receive the right care in the right setting by using evidence-based guidelines to determine the appropriate level and site of post-acute care.  The ultimate goal is to transition the patient to the home in a timely manner.  Our solution works with the patient throughout the entire care continuum.  We facilitate care touchpoints: from the acute hospital, through any required post-acute care settings, to the home.  Our ongoing provider engagement efforts, which include clinical program development and analytical services, ensure a best-in-class performing network of post-acute facilities.  Leveraging these core strengths, eviCore's Post-Acute Care management ensures appropriate site-of-service selection, safe care transitions, effective information sharing, and implementation of condition-specific clinical programs and patient-centric pathways.​

  

  

Everyone benefits through better outcomes

  • Plans

    Our Post-Acute Care solution works closely with the patient, assigned caregivers, and providers throughout each phase of the care continuum. Our solution influences elements of both Star ratings and HEDIS quality measures with high-touch collaborative programs, and delivers tailored patient-care plans with focused improvement goals.

  • Providers

    The eviCore Post-Acute Care solution relies on clinical protocols that utilize recognized evidence-based guidelines and CMS guidelines to determine medical necessity. Our significant experience in transitional care management and utilization management ensures that each patient receives the right care in the right setting.

  • Patients

    Our Post-Acute Care solution guides patient-centered care with personalized care plans, risk assessments, and transitional coaching to help ensure timely recoveries. We help patients navigate the healthcare system after hospital discharge to the appropriate care setting, applying timely recovery programs that avoid poor outcomes and readmissions.

  

The more we know, the better the outcome

A list of the most common post-acute care queries are provided below. For more detailed information, visit the Contact Us page.
What is Post-Acute Care?

At eviCore, the Post-Acute Care solution was developed to close the existing care gaps within the post-acute care continuum.  Our solution eliminates inefficiencies, decreases cost, focuses on transitional care efforts, and improves the quality of patient care.  The post-acute services include:​

  • Analytics
  • Utilization review
  • Site-of-service management
  • Network development and management
  • Transitional care management (clinical staff embedded within acute and post-acute facilities and dedicated facility assigned telephonic clinical teams)
  • Provider education.
Why is Post-Acute Care needed?

The continuum of care from hospital to home can be very fragmented, involving many teams of caregivers, multiple post-acute providers and services, as well as home-health options.  Each step of the post-acute decision process can be complex and provide a significant risk for re-hospitalization or a setback to clinical progress.  Our post-acute solution has been developed to proactively identify hazards to successful recovery and provide one consistent source of support throughout the care continuum.​

How does eviCore interact with Post-Acute Care patients?

Our nurse care managers begin engagement prior to hospital discharge, bringing evidence-based guidelines specific to the patient’s recovery needs into the discharge planning discussion.  We involve patients, patient’s families, their doctor and nurse teams, and community resources in order to create the most supportive and consistent recovery plan available.​

Who and what guides our Post-Acute Care?

Our teams of medical directors, RNs, and their support teams utilize a proprietary case management system built specifically for managing post-acute care through evidence-based and CMS guidelines.​

Where do you provide Post-Acute Care?

eviCore facilitates the delivery of post-acute care services in the most appropriate setting based on the patient’s medical necessity.  The frequency of transitional care touchpoints is based on each patient’s clinical needs and the nature of the post-acute care setting.  The modes of communication used may include in-person contact, telephonic, secure email/text, or a combination of methods.​