Begun in 1985, Geisinger Health Plan (GHP) is one of the nation’s largest HMOs, serving 290,000 members, and is ranked among the top health insurance companies in the country. Parent Geisinger Health System is a comprehensive healthcare network dedicated to community-focused, not-for-profit, physician healthcare, medical research and education, and serves 2.6 million residents in central and northeast PA.
GHP wanted to cut all-cause 30-day hospital readmissions among Medicare Advantage patients. GHP and AMC thought that telephonic IVR could be used to automate routine calls to identify care gaps, enhancing the case management program and improving quality of care. The telehealth component alerted care managers when gaps were uncovered, enabling them to intervene promptly to close those gaps. A total of 875 patients were enrolled in the study who realized a 44% reduction in all-cause 30-day readmission risk compared to a control group that had no IVR protocol.
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