USMM offers multiple home-based programs designed to improve quality of care, promote coordination of resources, reduce medical expenditures, and increase patient satisfaction.
USMM offers payers including Medicare, Medicaid and Commercial insurers a reimbursement model that emphasizes fee-for-value, rather than fee-for-service, focusing on care coordination and accountability.
Our solutions empower health care organizations with tools and actionable data for risk stratification, readmission management and risk adjustment optimization.
Home-Based Specialty Program Offerings
A complete picture of member health. A licensed Provider (Physician, Nurse Practitioner, or Physician Assistant) completes an individualized comprehensive assessment in the member's home or alternate location.
- Locally based provider network
- Focused on care resistant members
- Actionable data provided quickly to the health plan
- Direct Impact on HEDIS gap closure and STAR ratings
- Risk adjustment lift
- Improved revenue and quality outcomes
- Reconnect members to PCP
- Personalized member outreach campaign (phone and mail)
In-home Early and Periodic Screening, Diagnostic and Treatment (EPSDT) Services & Pediatric Assessments. High quality preventive health care program designed to provide comprehensive in-home periodic screenings for Medicaid-eligible children. Our skilled provider will educate member/member guardian on the benefits of preventive health care, encourage them to participate in regular screenings and identify those who may need further diagnosis, evaluation and/or treatment of any physical or mental health issues.
LAB2U testing services are performed by our VPA College of American Pathologists (CAP) accredited, state-of-the-art laboratory. The LAB2U Program is designed to close gaps in care and improve HEDIS® measures and CHAPS® scores. LAB2U kits are mailed directly to the member's home and include all items the member needs to confidently collect their sample and return it securely to the laboratory for testing.
The results of these tests can help members stay healthy, manage their long-term chronic illness, and improve their experience with the plan.
- Convenient for member to complete in the comfort and privacy of their home
- Dedicated staff available for telephone support
- Escalation process in place to alert case management of abnormal results
- Results communication to plan, member, and PCP
The program currently offers the following self-administered monitoring and screening tests to improve compliance with:
- Colorectal Cancer Screening
In-home Diabetic Retinopathy Exams help to meet HEDIS and STAR measures. This is a photographic exam with no dilation required. The program consists of both mail and telephonic outreach in which a exam is scheduled with a technician that captures photographic retinal images. The images are interpreted by a locally licensed Ophthalmologist or Optometrist. These images can also detect other eye diseases. Results are mailed to the member, to the member's PCP, and shared with the plan.
Our highly skilled registered nurses perform the telephone based assessment and corresponding documentation, which may be required initially and then annually for health plan members. The assessment helps to identify any additional services that would benefit the member.