Building a structure to support true collaboration

Helion's cross continuum collaboration and interdisciplinary approach resulted in better coordination of care and a reduction in hospitalizations for a high-risk patient.
collaboration
THE CHALLENGE

A young commercial member developed complications during a procedure that led to an anoxic brain injury. The patient’s case was not only clinically complex, with multiple hospitalizations and readmissions to both acute care hospitals and LTACs, but had complicated family dynamics as well. Helion collaborated across care teams to assist in managing the complexity.

HOW OUR SOLUTIONS MADE A DIFFERENCE

Facilitating collaboration is one of Helion’s strengths. As part of our Care Transition Architecture, we work to understand the challenges of payers and providers—and because we build strong relationships with both, we are often in a good position to help build a support structure that supports the effective resolution of issues.

In this situation, our collaboration with the teams included:
  • Facilitating root cause analysis meetings between the SNF (including SNF leadership and the SNF corporate team) and the health plan integrated care team for very high-risk members. Due to the member’s complexity and some family dynamics, SNFs located close to his family had refused to accept him. However, working together, the team was able to arrange for an out-of-network SNF to accept him.
  • Leading efforts to advance family acceptance of advance care planning and palliative care, when, despite efforts to manage the case, hospitalizations and readmissions continued.
  • Fostering dialog with hospitals and health systems where the patient had been cared for to support the agreed plan.

Results

Despite an exceptionally difficult situation, Helion was able to develop an interdisciplinary approach to mitigate further escalation of an exceptionally complex situation that benefited the patient, the family, the hospitals and health systems, and the providers who were caring for the patient.