Returning home from a hospital stay can challenge anyone, especially people with chronic conditions. For Colorado Medicaid members, Remote Support Services simplify this transition. Our program provides comprehensive support right in your home, ensuring a smooth and safe return to your daily life. We use technology to monitor your health, empowering you to take an active role in your wellness journey and prevent future complications.

Our Post-Hospitalization Procedure

Our simple process focuses on your well-being:

• Initial Contact: A member or family member contacts our agency to discuss their needs.
• Service Determination: We assess the member’s condition and decide if our chronic disease management services are right for them.
• Coordination with County/Case Manager: We contact the member’s case manager or county to confirm their benefits are initiated or enrolled. This step ensures a seamless process and proper coverage under Health First Colorado, the state’s Medicaid program.
• Initiating Remote Monitoring: Once we have confirmation, we start the member on remote monitoring to ensure their safety and track their progress. This allows us to proactively address any potential issues.
• Continuation Discussion: After the initial three-month period, we discuss continuing services to ensure the member continues receiving the care they need to maintain their health.

How We Monitor Your Health

Our remote monitoring program uses easy-to-use, at-home equipment to help you track your health vitals and communicate with your care team. The program combines devices and daily check-ins:

• Bluetooth-enabled blood pressure cuff: For those with hypertension or heart conditions, this device automatically sends your blood pressure readings to us, giving us a continuous picture of your cardiovascular health.
• Bluetooth-enabled weight scale: We use this to monitor for sudden weight changes. For conditions like heart failure, a significant, rapid weight increase can signal fluid retention and may need prompt attention.
• Pulse oximeter: This small device clips onto your finger to measure your blood oxygen saturation and heart rate. It’s especially useful for managing conditions that affect breathing, such as COPD or asthma, and provides a quick look at how well oxygen gets to your body.
• Daily phone questionnaire: You will have a brief daily check-in with your remote care coordinator by phone. This allows you to report on how you’re feeling, discuss symptoms, and ask questions. This personal touch ensures we can provide timely support and adjust your care plan as needed.

This regular monitoring allows our team to identify changes and intervene early, preventing complications and giving you a sense of security at home.

Benefits of Chronic Disease Management

Our chronic disease management program offers significant benefits to Colorado Medicaid members:

• Improved Health Outcomes: With continuous, proactive management, members can better control their chronic conditions, reducing the risk of complications and future hospitalizations.
• Enhanced Access to Care: Using technology and telehealth services, our program helps overcome barriers to care, ensuring members have timely access to medical advice and support. This particularly benefits those in rural or underserved areas of Colorado.
• Better Care Coordination: Our team serves as a central point of contact, facilitating communication between all healthcare providers involved in a member’s care. This ensures a well-coordinated treatment plan and effective communication of any changes.
• Increased Patient Engagement: By regularly monitoring their vitals, members become more engaged and knowledgeable about their own health. This empowers them to make better lifestyle choices and stick to their treatment plan.

Conclusion

Our remote support program provides seamless, personalized care for Colorado Medicaid members after a hospital stay. This approach benefits both the individual, by empowering them to manage their health safely at home, and the healthcare system, by ensuring resources are used efficiently and effectively. If you or a loved one are a Colorado Medicaid member returning from the hospital, our remote supports program can be a critical step toward long-term wellness and independence.