Home Health Care Program

PMSI's enhanced Home Health Care service is an entirely new approach to home-based care—evolving from a transactional business to a continuum of care management program. We take a patient-focused approach, using evidence-based guidelines to provide consultative advice based on timely information and expert insights. Our approach is driven by PMSI's focus on holistic cost containment across the claims lifecycle. Through a combination of care monitoring and service management, PMSI can save 8% - 12% or more in home health and related costs compared to individual, transaction-based fulfillment of equipment and services.

Building on the foundation of our enterprise-wide MedAssess™ Clinical program, PMSI applies established utilization guidelines, provides careful evaluation and actionable information to help ensure that care objectives are achieved and costs are contained. Structured to manage the complexities common to workers' compensation cases, this comprehensive program includes specialty nursing, aides and therapists with a rapid response commitment for service placement and confirmation. The result is reduced outlay for our clients and improved outcomes for injured workers—derived from PMSI's proven solutions for cost containment. PMSI Home Health Care services feature:

  • Single call service assurance
  • Single point of contact for all services
  • Customizable reporting options for total care management
  • Network of over 100,000 fully credentialed care professionals

 

Service Assurance

PMSI eases the burden of making numerous phone calls, juggling a multitude of providers and wasting hours searching for a provider and tracking down confirmations. With our Home Health Care program, you have assurance that with a single call all appropriate home health services will be coordinated and confirmation provided within four hours.

Comprehensive Approach to Care

Working with PMSI, you have access to the most extensive coast-to-coast network of qualified, local in-home care providers. From simple to complex, all of the services required for an injured worker requiring home health care can be coordinated with a single call. Our professional staff understands the continuum of care and can help coordinate injured workers’ special discharge situations—such as post-surgical wound care and catastrophic injuries—in addition to case logistics and unexpected therapeutic needs. Working with our team early in the care management process helps clients anticipate the needs of the injured worker based on the compensable injury and treatment plan, coordinate delivery, reduce costs and improve outcomes.Our enhanced Home Health Care service offering includes:

Skilled/Non-Skilled Care
In-Home Services
Specialty Services
  • High-tech nurses
  • Wound care nurses
  • RNs, LPNs and CNAs
  • Medical social workers
  • Home health aides
  • Companions and sitters
  • Physical therapy
  • Occupational therapy
  • Respiratory services
  • Speech therapy
  • Infusion therapy
  • Home modification
  • Vehicle modification
  • Transportation
  • Orthotics and prosthetics
  • Durable Medical Equipment
  • Medical supplies
  • TENS and TENS supplies

Information-Driven Consultative Approach

PMSI understands that positive outcomes are driven by medically necessary and appropriate care. A PMSI Care Specialist will provide continual follow-up with the injured worker to verify that care is progressing on target with treatment objectives. Issues are identified early for successful resolution. Care management calls to the injured worker are made, at minimum, once per month, and are based on the care management plan. Weekly nursing notes provide the status information clients need to support critical care decisions. Delivery of nursing notes may be customized to fit client management needs. Our program is guided by credentialed clinical experts to ensure proper care and provide clinical recommendations for consideration based on the case-specific care objectives.

Commitment to Care Excellence

Beyond our Care Specialists, the foundation of our Home Health Care program is our extensive nationwide network of care providers—over 100,000 fully credentialed care professionals in over 1,170 locations. Since it takes more than a large network, PMSI works with our contracted providers to establish rigorous credentialing requirements, monitor performance and provide compliance reviews. Our contracted rates provide market competitive pricing and our Vendor Report Card program monitors performance and provides feedback on vendor service.

Better Services, Better Results

PMSI is committed to delivering services and tools that help you manage high-exposure claims simply and cost effectively.

  • Care management tools – ensure proper care with nurse notes, clinical advice, utilization reports and case reviews.
  • Reporting – see the big picture with timely management information and extensive benchmarking.
  • Outcomes – utilize insightful and managed programs that increase the quality of care and reduce administrative burdens with a focus on strong return-to-work results.