Home Health Coordination

Keep members happy and healthy at home—not the hospital.

As America’s aging population continues to grow, more elderly individuals—as well as those with mental illness, intellectual or developmental disabilities, and/or physical disabilities—are choosing to forgo care in nursing homes, hospitals, and other institutions in favor of receiving medical care and support in their own homes. By keeping these members in the home and community settings they know and trust, health plans successfully avoid expensive long-term care while reducing hospital readmissions and allowing members to live life to the fullest.

From personal care assistance to home modifications, MTM holds a strong commitment to connecting members with care. We know that coordinating home health services can be a daunting task for health plan Case Managers—as an expert network manager, MTM is here to balance these responsibilities. Our Service Coordinators partner with your Case Managers to relieve the burden of coordinating disparate provider networks, allowing your staff to focus on other care needs while we worry about the rest.

MTM can coordinate every service within your home health network:

  • In-home healthcare
  • Transportation
  • Translation
  • Personal care assistance
  • Home modifications
  • Meal preparation
  • Social reengagement
  • Durable medical equipment (DME)
  • Rehabilitation therapy
  • Telehealth
  • Pest control
  • Equine, canine, and art therapies

MTM can help you:

  • Improve continuity of care
  • Reduce fragmentation
  • Provide enhanced person-centered care
  • Realize significant cost savings

Our Approach to Home Health Coordination

With more than 20 years of experience and expertise coordinating networks of high quality transportation providers, network management is the heart of MTM’s operations. Much like our approach to non-emergency medical transportation (NEMT) management, our model for home health coordination relies on a complex structure of service providers capable of meeting members’ daily needs to ensure they receive high quality, timely care. Utilizing these networks, MTM assembles all critical functions of home healthcare and integrates them into one unified, person-centric solution.

By providing services that promote independence and remove barriers to care, MTM helps improve members’ overall health and wellbeing while simultaneously delivering cost savings. Our home health coordination model revolves around three program pillars that ensure continuity of care, improved health outcomes, support for caregivers, and increased member satisfaction, all while lowering healthcare costs by reducing the use of more expensive hospital and nursing home care.

 

The Three Pillars of Home Health Coordination

Network Oversight

Network Oversight

With the broad scope of networks needed to support unique populations, MTM realizes that network oversight can be a large challenge. More so than any other home health coordinator, we offer extensive processes for managing robust networks of service providers. Our more than 20 years of experience recruiting, credentialing, and contracting transportation providers has formed our approach for developing qualified networks of home health service providers. To ensure member safety and satisfaction, each vendor undergoes our rigorous credentialing process, which is inclusive of background and certification checks; we can even help you design these credentials to meet plan requirements. To ensure high quality services that result in continuity of care and full member satisfaction, MTM also carefully monitors providers through regular field monitoring and inspection activities.

Quality Standards

Quality Standards

MTM strives to provide the highest level of service by demanding quality from our network providers. We realize our clients are held to high standards by the Centers for Medicare & Medicaid Services (CMS), and we help health plans meet these stringent requirements by keeping close watch over home health provision. We are URAC accredited and maintain satisfaction rates exceeding 95%. To keep this rate high, we are proactive in our improvement efforts by monitoring service, performing audits, conducting weekly satisfaction surveys, and addressing all issues immediately. MTM also offers a comprehensive process for managing, resolving, and reporting complaints and grievances. Quality measures and outcomes are reported on a monthly basis to ensure all appropriate standards are met.

Encounters & Billing

Encounters & Billing

Organizing encounters, claims, and billing can be a tedious process. Our flexible system is capable of paying providers for their services in a timely manner, and our Network Management staff are experts in negotiating competitive rates to achieve responsible cost savings. Additionally, MTM coordinates billing efforts, offering clients our ability to consolidate claims from multiple providers for all services into a single monthly billing statement to save a great deal of administrative time and recordkeeping. We are also familiar with developing encounter submissions for health plans, and can assist with capturing and preparing this information. This includes matching claimed encounters with approved services and frequency, checking appropriate codes, and authorizing payment. Our encounter submissions are timely, accurate, and compliant with all state and plan requirements.

GA Foods
MTM proudly partners with organizations like GA Foods to provide critical home and community based services that promote positive health outcomes and support members where they are most comfortable: their homes.