Maximize Impact With High‑risk Targeting
Guideway’s High‑Risk Readmissions program concentrates on the segment of patients who are most likely to return within 30 days. Using proprietary risk stratification, we identify patients with complex comorbidities, frequent past admissions and significant social needs. Our Activation Care Guides then deliver tailored support and motivational coaching, ensuring resources are directed where they have the greatest return on investment.
What We Do
- Provide weekly outreach to monitor symptom escalation and compliance with treatment plans.
- Resolve transportation, medication or financial barriers that disproportionately affect high‑risk individuals.
- Coordinate care across multiple providers and specialties, including social services.
- Involve family caregivers and support networks to strengthen adherence.
Benefits
- Significant reductions in readmissions and uncompensated care.
- Better alignment with value‑based payment models.
- Increased patient engagement and satisfaction in complex cases.
- Enhanced health equity through focus on vulnerable populations.
