Published by Angela Muth on May 2nd, 2019

Hospitalization is a big deal for clients and members, both financially and emotionally. Through our in-house team of healthcare management professionals, we work to help reduce the need for hospital admissions and re-admissions among our client populations by educating members, empowering them, and assisting them in their personal health journeys.
We built our in-house, fully integrated program upon a foundation of true caring, beginning with our dedicated team of nurses—representing decades of experience and covering over 70 specialties and sub-specialties. We bring a spirit of caring service and join it with industry-leading data and analytics so we can better serve our clients and their populations. Through our decades of experience with patients, and the industry, we have found several effective steps to help improve outcomes for patients after hospitalization and reduce the financial burden of unnecessary re-admissions. In 2017, our case management and utilization management programs helped to increase savings to our clients by 183%—just under $3 million dollars per month—and delivered a combined ROI of 4:1.

Three key factors contribute to improved outcomes for our members after hospitalization. Is the member:
  • Informed about their condition and treatment plan?
  • Receiving and taking their medications as prescribed?
  • Making it to their outpatient follow up appointments?
We help our members get to “YES” for those three questions.

Communication is Key

When we become aware that a member requires medical care or has been newly diagnosed, we conduct outreach. Trustmark Health Benefits nurses reach out to the member, to ensure that they understand the diagnosis and the treatment plan that their healthcare provider outlined for them and to answer any questions they have. We provide the member with information and address their concerns. We serve as one point of contact for members who maybe do not quite understand what the physician just told them during their office visit, or what the potential impact of a planned surgery might be on the member and their family.

We are advocates for our members.
But an equally important part of the process is to conduct follow up communications with the provider, to get any clarification that might be needed on the treatment plan and any rehabilitation to make sure that the care that our members receive is medically appropriate and done in an appropriate time frame by the most appropriate provider.
Additionally, if we have a patient that is hospitalized, we are working with the hospital’s case management team or social workers to ensure that everything our member needs is in place, so that the member’s course of treatment continues when that member is ultimately discharged from the hospital. Discharge planning is crucial for reducing the chance that the member will need to be re-hospitalized.

We Stick Around

The time after discharge can be pivotal for members, and we are there for them. Our in-house nurses check in on their symptomsand medications to make sure they stay engaged with their providers and that they understand their options for treatment for any complications that may arise. We strive to empower members, through our continued assistance, to take charge of their healthcare.

Just as we continue to be a resource for members after hospitalization and try to limit hospital re-admission, we are also looking into ways to prevent the need for a hospital stay in the first place. Through our data analytics vendors, and access to their vast aggregations of data, we are able to take a holistic view of our members—before illness—to identify members who we can help through early intervention. Through the data, we can spot members with risk factors, such as unfilled prescriptions or missed doctor’s visits, so we can help them--before they need help--so they can maintain healthier lives.

The Trustmark Difference

Healthcare Management is one way that Trustmark is different. We recognize that our clients have many options for a healthcare management provider, but we believe that our caring spirit and our dedication to the holistic health of our members and clients sets us apart. We would love to have the chance to demonstrate the value of Trustmark Healthcare Management, and the difference it can make in the lives of your clients and their members.