The ILS Post Acute Support System (PASS®) is adapted from the Care Transition Intervention (CTISM) program developed by Eric A. Coleman, MD, MPH at the University of Colorado at Denver Health Science Center. CTISM is a patient-centered intervention designed to improve the quality and contain costs for patients with complex care needs as they transition across settings. ILS offers this program to assist managed care organizations and hospitals to reduce readmissions to the hospital setting and improve overall quality of care. The Problem The Centers for Medicare and Medicaid Services (CMS) recently announced that 19.6% of Medicare patients and 16.5% of Medicaid patients with comorbidities, discharged from acute inpatient care are readmitted to the hospital within 30 days, costing over $15 billion annually. A large percent of hospital readmissions are "potentially" avoidable. These soaring readmission rates represent a problem not only for the patient and family, but for the payers and hospitals, who may be held financially liable for the readmission costs, especially those that are considered avoidable by CMS and other regulators. Our Solution PASS® is a patient-centered intervention designed to improve the communication and coordination of services for patients with complex care needs as they transition across settings. The PASS® program incorporates the PASS® Coach who follows the patient during their transition from acute hospitalization to the home, providing the supporting bridge for the patient and the caregiver during the process. The PASS®Coach is supported by the PASS®system and the PASS® Care Coordinators.
Coaching For Success The PASS® Coach performs in-person patient/caregiver visits in the hospital and in the home, followed by continued telephonic contact. The PASS®Coach establishes and builds a patient specific personal health record utilizing the PASS® pillars: 1. Medication Management 2. Nutrition Management 3. Patient Health Record 4. Primary Care & Specialty Follow-up 5. Red Flags / Signs & Symptoms The PASS® program emphasizes:
Overview
ILS currently provides management services to several major healthcare organizations that participate in Long Term Care Nursing Home Diversion and Special Needs Programs. These services provide frail and elderly adults with safe, appropriate community-based care alternatives in lieu of nursing home placement as a cost effective alternative to Medicaid nursing home care.
To support our managed care clients with Long Term Care and Integrated Care Program initiatives, ILS provides a turnkey solution that incorporates provider network contracting, credentialing, and management with member support / care management and claims administration through an integrated web-based technology platform.
Provider network Management
ILS has multi-regional Home and Community Based Services provider networks that can be used by managed care clients to support LTC and Integrated Care Programs. Contracted and credentialed providers include but are not limited to:
More than just a technology solution, however, ILS Provider Network Management Program offers industry veterans with knowledge of state regulatory requirements and the experience to build provider partnering relationships in local marketplaces.
Member Support / Case Management
ILS systems were designed from the ground-up to support the unique needs of individuals being served in a variety of long term care and community settings. Enrolled Individuals can be automatically submitted to approving authorities via EDI transactions; auto-queued for assessments; and production of care plans upon approval.
Assessments and Care Plans can be generated in real time by staff in the field through a secure web browser interface. Care Plans are then used to produce referrals to providers and generate the authorization numbers against which claims are paid.
Claims Administration
Unique to the targeted population programs, ILS has developed a claims adjudication system that while faithful to the basic precepts of the managed care industry has incorporated numerous additional features that support long term care and targeted population providers including:
ILS Technology
The ILS Long Term Care System is the ILS Cloud-based, member centered application that provides Case Management, Medical Management, Financial and Administrative support capabilities to support any targeted population of our clients. Features of the system include: Member Management
Nutrition/Meals Services ILS Meals (www.ilsmeals.com) programs offer a comprehensive approach to its client’s nutritional needs. A team of registered nutritionists create and oversee a full menu of healthy prepared meals and gourmet style food delivered nationwide to an individual home or facility. The program is uniquely designed to improve the overall health and emotional well being of its customers. Customers can choose from the following meal types:
RenalHealth Products - Nutritional Support for Dialysis Patients:
ILSMeals RenalHealth products offer a safe, convenient solution to help patients undergoing dialysis treatment maintain a healthy nutritional status. Malnutrition is often a common result of dialysis. The procedure itself causes a loss of essential vitamins and a decrease in protein synthesis. Dialysis patients that self-select their diets often suffer from protein-calorie malnutrition. ILS Meals RenalHealth and RenalHealth+ provide kidney friendly meals specially formulated and nutritionally appropriate for dialysis patients requiring lower amounts of potassium and phosphorus or other dietary insufficiencies. Our RenalHealth+ package also includes quality protein and vitamin supplements for those patients that require a higher protein diet and /or need to supplement nutrients lost through dialysis treatment or a restrictive diet. Click here to view our RenalHealth brochure and menu.
Post-Discharge Program: Clients in this program receive a telephonic post discharge nutritional assessment scheduled for 24 hours after discharge and 30 days after the initial survey. Since nutrition plays a critical role in recovery and rehabilitation, understanding the unique needs of each client is a core competency of this program. Key features include:
Community Based Meals Program: ILS currently provides congregate and/or home delivered meals to an array of community based organizations such as Jewish Community Services, Miami Jewish Home and Hospitals for the Aged, and is the meal provider for several nursing home diversion programs in the state of Florida. Additionally ILS has received ARRA funding in the past to further reach the local Miami community with congregate and home delivered meals. Individual Meals Program: ILS Individual Meals Program, by way of innovative food products, has been revolutionizing the way busy Americans eat. While searching for the best home delivered meals, we have been able to create a full line of specialty meals such as special meal plans for the Elderly that include a range of precooked meals. Senior Meal Delivery, senior meal programs, senior food and meal delivery. ILS also provides a full line of foods or food items that can be used as food gifts, such as meals for seniors. We offer seniors discounts and meal plans for your any life style. Our online ordering makes it easy! Look to us for heart-healthy, carbohydrate controlled prepared food. Seniors love these meals; they are easy to reheat and are delivered frozen. And, at the end of the meal - there's no clean-up! ILS meals offers meals that are appropriate for customers with the following conditions:
Special Needs and Chronic Meals Programs Clients in this program receive a telephonic nutritional assessment scheduled for upon receipt or eligibility information. Meals are nutritionally balanced; carbohydrate, fat and sodium controlled, and are suitable for members with chronic disease such as diabetes, hypertension, high cholesterol, heart disease, etc. Key features include:
All programs offer meals that meet or exceed USDA recommended dietary allowances of nutrients. A recent survey of consumer nutritional accounts revealed a 97% satisfaction rating for taste, appearance, portion sizes and variety. A state of the art, multi lingual call center is available Monday – Friday 8:30 a.m. to 5:00 p.m. Call Meals 1-800-460-7176 for more information