Post-acute navigation supports patients from the emergency room, urgent care, and other acute care settings to ensure that patients are empowered with the tools and resources to support their recovery. Navigators carefully execute a patient’s care plan through thorough review of a patient’s history and barriers they face to achieving optimal outcomes. This approach is tailored to meet both the patient’s needs and care teams goals, such as scheduling appointments, confirming transportation, and providing guidance and resources that address the unique social determinants to their health.
A 53% decrease in high-utilizer ED revisits resulted in a saving of $418,781 over one year.
A reduction of 337 avoidable ER visits for Medicaid, Managed Care and uninsured over 2 months resulted in $85,000 in savings
~20% of navigated patients received same-day or next day appointments for Primary & Specialty Care
9/10 patients would recommend using a navigator to friends and family” and 96% reported satisfaction with their navigator services
“We have been able to capture many high-utilizer patients that were using the ER for primary care services. The ER Navigators have been able to help educate patients about the proper use of healthcare services. We have been able to connect Medicaid patients with services they didn’t even know they needed or were even offered.”
- Case Management & Social Work Team at AMITA Health, IL
The Substance Use Navigator (SUN) plays a critical role in ensuring those patients suffering from substance disorder not only have access to appropriate medication but adhere to their prescribed treatment plan. While embedded within an emergency department or inpatient setting, the SUN collaborates with the patient and care team to initiate addiction treatment, coaching and resource management, behavioral health and social services, as well as community support.
37% of engaged patients were treated with buprenorphine
29% of engaged patients attended a follow-up visit for medication-assisted treatment after discharge from hospital
"The initial goal of this program was to bring resources to patients needing help with substance use disorders. What we have found, however, is that the work that the SUN does goes far beyond just providing resources. He is giving people their lives back. He is giving families their loved ones back. The SUN has been so successful that he is now often called by nurses and physicians in the inpatient units to come help patients and set up a plan for discharge. We have joined together with our peers throughout the hospital and have been able to make the Opioid Honor Role. Having a Substance Use Navigator has transformed the care of our patients with substance use disorders and has helped us create a significant impact on the community we serve. As our SUN continues to partner with our street nurses and community outreach groups, I know that this tremendous impact will only continue to expand and touch more lives.”
- Medical Director
We understand that the transition home for a patient after a hospital stay can be a difficult and complicated process. Our Navigators work closely with physicians, nurses, and support staff both within the hospital and in the community after discharge. They help to coordinate referrals and appointments, follow the care plan, and provide emotional support, encouragement and education for patients, families and caregivers to support successful recovery.
22.2% Reduction in 90-day all cause readmissions
23.6% Reduction in 90-day readmissions for Sepsis bundle
$5,136 Average savings of Medicare dollars per patient for 90-day episode
“We had a patient who had been admitted several times and had an emergency room visits a few days prior for what appeared to be related to the same medical complications. Upon review of the chart, the Navigator noticed that patient’s family had requested education of diabetic nutrition and medication administration. The patient’s primary care provider was located outside of the hospital system network and required several phone calls from Navigator and care team to gain approval for a referral. Additionally, the patient was unable to make decisions for himself and relied on several family members to care for him. Multiple calls were made between the Navigator, family, and Providers until the Navigator was able to get the patient into the doctor’s office and secure a home health referral. Once the referral was made, the Navigator continued communication with the family to ensure that the patient was able to get meals on wheels and receive home health services. During the period of care, the Navigator also helped the patient with medication needs. To date, the patient has not been readmitted and appears to still be living in his own home with family support.”
- CMO
Healthful's navigators identify patients at high-risk for avoidable return visits to the emergency department
1 We assess and co-design a program to achieve your goals; from ensuring proper transitions for patients, to navigating the nuances to the healthcare landscape
2 Our Navigators identify specific healthcare needs for patients, caregivers and family.
3 We then guide patients to the resources needed to support a holistic, satisfying healthcare journey
Healthful’s Scribe Services was born out of a need to relieve physicians of the growing burden of clinical documentation. Healthful’s Scribe Services has grown both vertically and horizontally with scribes servicing multiple specialties, including emergency and hospital medicine, urgent care, and many outpatient specialties.
At Healthful, we are hyper-focused on solving the needs of our patients and clients. Here are some things they have said about us:
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