Guideway Care Success Stories

Avoided In-patient and ER Visits for Medicare Patients

The Challenge

A large, California-based Medicare Advantage plan administrator needed an effective way to lower rates of avoidable utilization and deterioration.

Guideway’s Solution

The target population received care guidance services to identify and lower barriers to care and preventative services. The goal was to lower avoidable inpatient (IP) and emergency department (ED) visits.

Results Delivered

Within the first two months of the program, Guideway Care reduced in-patient admission rates by 79 percent and emergency department admission rates by 50 percent for the target member population. Sixty-day costs avoided totaled more than $103K.

Readmission reduction by target condition:

IP: Reduced Readmissions by 79%
ED: Reduced Readmissions by 50%

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Patient Vignette

Appointment Scheduling and Adherence: Addressing Gaps

After multiple unsuccessful outreach attempts, a patient returned a Care Guide’s call requesting assistance. He missed an appointment and wanted help rescheduling. The Care Guide was able to reschedule the appointment successfully and assist with securing transportation.

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Patient Action.

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