Article | 05/02/23

Post-discharge: A critical moment for health plans to support caregivers

This article originally appeared in Becker’s Payer Issues on May 1, 2023.

Hospital stays – particularly for seniors and patients with complex care needs – are stressful and overwhelming. Hospital discharge processes are confusing and insufficient. And, that is rarely the end of the challenge. When someone is discharged from the hospital, they often return to their home in a new state of “normal” — one with likely escalated vulnerability and support needs.

Efforts to reduce hospital lengths of stay have led to an increase in post-acute care services use and a reliance on loved ones. Nearly 52% of people discharged from the hospital to their home report receiving help within three months of discharge. And unpaid caregivers provide 80% of that care, according to the Centers for Disease Control and Prevention.

These caregivers are left to navigate a fragmented benefits and care system while juggling new, difficult responsibilities on top of their existing to-do lists. In the weeks after a hospitalization, caregivers perform numerous indispensable tasks, including care coordination, fall prevention and in-home safety, medication adherence, transportation to follow-up appointments, and more — bearing a heavy burden, typically on their own.

For health plans, the 30 days post-discharge are already critical as part of readmission reduction efforts. Most plans have employees who support members through these transition periods — utilization managers, case managers, care coordinators, care transition managers and discharge planners with a shared goal of keeping members out of the hospital.

Now is the time to support the unpaid caregivers who act as an in-home extension of those existing teams during the post-discharge period. Doing so can lower health plans’ costs and improve their member experience.

For health plans wanting to avoid costly unnecessary readmissions, post-discharge is a critical moment through which to engage caregivers. Caregivers for members already play a leading role in their health and use of the healthcare system, and at no point is that role more important than after a hospitalization.

One study found that involving family caregivers in discharge planning can reduce readmissions by 25%. Another found that patients with engaged caregivers are 30% less likely to go to the emergency department.

Member experience is also more important than ever for health plans, with Medicare Star ratings putting more weight on CAHPS results starting in 2023.

Unfortunately, post-hospitalization is a time when members and their caregivers are more likely to experience abrasion in their health plans’ processes as they work to navigate benefits and heightened care needs.

Insurance providers can rise to the occasion by offering a post-discharge caregiver support program. Building trust with members’ caregivers and giving them the information and support they need will make them more effective caregivers and impact scores for health plan customer service and overall health plan rating when the CAHPS survey comes.

A proven need

In Carallel’s experience, members’ caregivers actively seek out support in the weeks after discharge when it’s available.

One post-discharge program designed for major regional health plan offered Medicare Advantage members’ caregivers digital tools and touchpoints with care advocates after the member came home from the hospital. Caregivers averaged 10 touchpoints in the first eight weeks, demonstrating high demand for this type of service. Additionally, nearly 90% of participating caregivers wanted continuing support, signaling that caregivers want guidance as they continue navigating their caregiving journey.

Caregivers act as in-home, unpaid utilization managers, case managers, care coordinators, care transition managers and discharge planners. When health plans support them through a post-discharge program, they can improve member experience while keeping them healthier at home.

About Carallel

Carallel uses expert guidance and digital tools to identify and empower caregivers so they can confidently manage the twists and turns of caregiving. Carallel partners with health plans and providers aiming to achieve better outcomes, and employers striving to retain employees and increase productivity.

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