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VNS Health TODAY | Winter 2024 | Volume 3, Issue 1

Expanded Role for Physical Therapists Benefits Patients and Nurses

VNS Health physical therapist and patient
VNS Health’s physical therapists have been starting more home care cases and removing certain surgical wound dressings themselves. This allows patients to begin physical therapy sooner after procedures like total joint replacement, while freeing up nurses to focus on more complex cases.
Over the past year, VNS Health has widened the scope of activities for its physical therapists (PTs), empowering them to remove certain types of surgical wound dressings and start more home care cases themselves. This optimizes care by enabling patients to begin physical therapy sooner after procedures like total joint replacement, while freeing up nurses to focus on more medically complex patients.
“As the pandemic eased up, we were looking for ways to ensure all of our clinical staff are operating to the fullest extent of their training and capabilities,” explains Joseph Gallagher, Director, Operations Support Services for VNS Health. “By default, we’ve always sent our nurses to take care of anything wound-related—including removing Mepilex dressings, which are commonly used and very simple to take off. Once we realized this was something our PTs have the clinical expertise and license to do, we began training them in the procedure.”
Following the success of this approach, the VNS Health Home Care team recently began training their PTs in the removal of Prevena wound care systems as well, which employ wound vacs to help drain the surgical wound after an orthopedic procedure. Because nursing care is no longer needed for these orthopedic surgery patients to begin physical therapy, VNS Health PTs are now opening many more home care cases themselves—enabling each patient’s rehab therapy to start sooner.
“By freeing up our nurses from doing orthopedic starts of care, this new protocol also allows the organization to accept more home care referrals overall,” adds Gallagher. “Plus, our PTs report feeling more attuned to the patient’s wound status, since they’re involved in the wound care process from the beginning.”
“Our intake team is now looking at every patient that’s referred to us to see if they’re eligible for a PT start of care,” says Angela Fallon, Director of Strategic Account Development. “We’re also working closely with orthopedic practices to educate them about this new approach, and to let them know we can start their surgery patients on home-based physical therapy as soon as they’re discharged—so send them our way!”
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CMO After-Hours Team Helps Keep Health Plan Members Safe at Home

Andrea Henry
Since VNS Health launched its Care Management Organization (CMO) ED Diversion program in 2023, hospitalization rates for the health plans that VNS Health services have dropped 10 to 15%.
When Andrea Henry, a nurse care manager with VNS Health’s Care Management Organization (CMO), spoke to her 74-year-old client, Barbara*, on the phone, she could tell something was wrong: Barbara, who suffers from asthma, was experiencing persistent coughing and shortness of breath. She’d received medicine for her cough from an urgent care center, but Andrea suspected deeper issues were involved.
Their conversation took place as Andrea’s work day was ending, but fortunately that wasn’t a problem: Andrea quickly referred Barbara to a nurse practitioner (NP) who was just starting her own shift with the CMO’s new ED Diversion team—a group that provides telephonic and virtual support to CMO clients from 4:30 p.m. to midnight during the week and from 9 a.m. to 3 p.m. on weekends and holidays. Because these NPs, who are advanced practice nurses, have prescribing powers, they’re well-equipped to address clients’ symptoms, contact their physician, and even call in a paramedic if necessary, thereby avoiding a hospital visit.
“Evenings and weekends are when people are most likely to end up in hospital emergency departments, because doctors’ offices are closed then,” explains June Stanley, Vice President, Clinical Strategy and Development for VNS Health. “By offering medical support after hours, this program aims to prevent trips to the ED that may be avoidable.”
According to Stanley, the ED Diversion unit is doing just that: Since it launched at the start of 2023, hospitalization rates for the health plans that VNS Health services have gone down 10 to 15%.
In Barbara’s case, when the NP began going through her medications over the phone, she discovered Barbara had misplaced her rescuer inhaler and was also having difficulty opening the bottles of meds she did have on hand. To relieve her shortness of breath, the NP immediately contacted Barbara’s pharmacist and had an inhaler delivered promptly to her home. The NP also sent Andrea a note regarding Barbara’s other medications, leading Andrea to order a switch to easy-open blister packs once she was back at work the next day. The NP also made sure Barbara’s physician was aware of the changes. With these interventions, Barbara’s health quickly stabilized.
Like the CMO as a whole, the ED Diversion unit’s ultimate goal, says Stanley, is to help health insurers keep their plan members safe at home by providing this additional support. “Our care managers and regular on-call NPs do a great job of this during regular business hours,” she adds. “But as we all know, health problems have a habit of cropping up at odd times. By filling that after-hours gap, this program is providing another crucial layer of care.”
*The client’s name has been changed for privacy.
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Managing the Health of the Most Complex Patients and Plan Members

An interview with David Rosales, who recently became VNS Health’s Executive Vice President and Chief of Provider Services. He previously was EVP and Chief Strategy Officer.

David Rosales
What would you say is VNS Health’s greatest strength as an organization?
I think it’s our ability to build trust with our patients and their families and change the entire direction of their lives. That’s why so many providers in the community trust us to take over and manage a patient’s care after that person has left their hospital, or after someone has experienced a wrong turn in their health. It’s something we do tens of thousands of times a day—and when we do, that’s where the magic happens.
What are your key priorities as Chief of Provider Services?
One of our key priorities is enhancing the experience of our team members who provide direct care to our patients and clients in our Provider businesses—which include Home Care, Hospice, Personal Care, Behavioral Health and Care Management. VNS Health is very well-positioned to care for the most vulnerable members of our communities, especially those with medically complex needs, and we have over a century of expertise with this population. Our vision is to increase the number of people whose lives we’re impacting, and do it within the context of today’s workforce dynamics. The competition for clinical health workers has increased dramatically in the post-COVID world—so for us to expand our reach, we first have to make sure the experience of our team members each day is engaging, frictionless, and attractive.
What are you doing to ensure this?
Intensive care management
“The challenge health plans struggle with most is how to change the health trajectory of individuals with very complex needs,” says David Rosales, EVP and Chief of Provider Services. “A key part of our strategy is to offer intensive care management solutions to health insurers.”
For our team members in the field, what makes their jobs attractive is the ability to engage one-on-one with patients and their families in a home or community setting. At the same time, these are challenging jobs, so we’ve been working to strengthen the systems of support we surround them with. We’ve been holding regular round tables with our field staff and managers, and we’re using those insights to make meaningful changes. For example, we recently established a dedicated preceptor role—team members whose only job is to guide, support and mentor our new clinical hires—and we’re expanding our Nurse Residency program for nurses who are new to home care. We’re also streamlining the workflow of our clinical field managers so they can focus more on their field clinicians. In addition, of course, we’re very focused on ensuring that VNS Health is competitive when it comes to compensation and benefits.
What other strategies are you employing to expand VNS Health’s impact?
We’re very focused on partnering with external health plans, which we see as one of our best opportunities to expand our reach. The challenge those plans struggle with most is how to change the health trajectory of individuals with very complex needs. That’s something we’ve become quite good at, so a key part of our strategy is to offer intensive care management solutions to health insurers. A good example is our Behavioral Health team’s substance use care management program, which launched in 2023. By engaging individuals with substance use disorder at the time they’re being discharged from inpatient stays, we can connect them to the services they need to continue on the path to recovery. Health plans have limited tools available to help these plan members—but through our care model, we’re able to fill that gap and link their members to essential services that support their recovery.
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Research Study Aims to Empower Hospice Family Caregivers

Research Study
The VNS Health Hospice team is part of a study investigating how increased guidance and educational support for families of hospice patients may benefit the patient’s and family’s quality of care.
Receiving hospice care in a home setting is most people’s preference—but for a hospice patient’s family, navigating their loved one’s final weeks can be challenging, even with the support of a professional hospice team. In an attempt to ease this situation, the VNS Health Hospice team and the VNS Health Center for Home Care Policy & Research are taking part in a research project on the benefits of increased guidance and educational support for families of hospice patients.
In the ongoing study, a collaboration between Weill Cornell’s Division of Geriatrics and Palliative Medicine and VNS Health called I-HoME (Improving Home hospice Management of End-of-life issues through technology), family caregivers receive weekly telehealth consults along with access to a series of educational videos, all with the goal of empowering them and helping them manage their loved one’s symptoms more effectively.
The NIH-funded research project is evaluating a pair of interventions designed to prevent families from feeling that their loved one’s symptoms are out of control, potentially causing them to panic and call 911. When this happens, the loved one may end up with an unplanned trip to the hospital, which could result in unwanted treatments and disenrollment from hospice.
The interventions provide participating hospice families with:
  • Up to six weekly telehealth visits with a hospice nurse practitioner (NP). The NP uses these sessions to guide and educate the family on the four key components of symptom management.
  • Access to an online library of short (two- to five-minute) hospice caregiver educational videos, with the NP recommending specific videos to them as needed.
“By providing hospice family caregivers with these weekly telehealth visits and the educational videos, our aim is to help them get better at assessing and lessening their loved one’s symptoms, thereby reducing unwanted discharges from hospice,” says Dr. Ritchell Dignam, Chief Medical Officer for VNS Health Provider Services. “If this intervention proves successful, the ultimate outcome will be an improved quality of care for both hospice patients and their caregivers.”
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VNS Health Medicare Plans Show Robust Enrollment Growth for 2024

VNS Health Medicare Plans
The robust growth of VNS Health’s Medicare plans is credited in large part to the plans’ benefit packages, which are carefully crafted to meet the needs of New Yorkers in the lower income ranges.
Driven by solid gains during last fall’s annual enrollment period, VNS Health is reporting significant membership growth in 2024 for its Medicare Advantage plan, EasyCare; its Medicare dual-special needs plan, EasyCare Plus; and VNS Health Total, its integrated Medicare-Medicaid plan. EasyCare saw a 34% increase in members coming into the current year, while EasyCare Plus expanded its membership by 60% and Total’s enrollment grew by 25%.
“Within our categories of health plans, we had some of the strongest enrollment results in the entire downstate market, and that’s continuing through the rest of the first quarter,” says John Burke, Executive Vice President and Chief of Health Plans for VNS Health.
David Robinson, Vice President for Health Plans Sales and Partnership Development, credits the plans’ strong performance to a number of factors, including the high quality of the plans themselves and an active marketing presence. In particular, he points to the plans’ benefit packages, which are carefully crafted to meet the needs of New Yorkers in the lower income ranges.
“We have some of the best benefits in the market, especially when it comes to supplemental benefits, and we’re seeing the market respond to that,” Robinson says. “We really try to care for the whole member, not just the medical component. Our over-the-counter pharmacy and grocery benefits, for example, are substantial. This allows our plan members to fill in the gaps from a social determinants of health perspective—including food insecurity needs that may not be covered through their SNAP benefits. We also offer a flex utility benefit that helps members cover some of their monthly gas and electric bills.”
In addition, notes Robinson, “We continue to grow our physician network, including adding providers serving New York’s Chinese and South Asian communities, which has helped drive people’s decisions to join our plans. We’re now hiring additional staff with similar cultural backgrounds to serve members of these communities, and we look forward to maintaining and growing those neighborhood connections.”
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Mother Cabrini Health Foundation Awards VNS Health $1.8 Million to Expand Its Nurse Residency and Veterans Programs

VNS Health Medicare Plans
A recently announced $1.5 million grant from the Mother Cabrini Health Foundation will be used to expand the VNS Health Nurse Residency Program, which provides nursing school graduates with hands-on training in home health care.
The Mother Cabrini Health Foundation (MCHF) has awarded two grants to VNS Health community impact programs—a $1.5 million, multi-year grant to expand VNS Health’s Nurse Residency Program, which provides recent nursing school graduates with hands-on training in home health care; and a $300,000 grant to the VNS Health Veterans Program, which gives specialized care and support to military veterans in home care or hospice, including help accessing their VA benefits.
The Nurse Residency Program grant, which runs through 2026, will be used to add an additional nurse cohort to the Nurse Residency Program, provide educational support for program participants and graduates, and seek program accreditation from the American Nurses Credentialling Center.
“We’re honored to have been chosen as recipients,” says Monica Cayemitte, Clinical Director for the program. “This grant will play a crucial role in our efforts to increase access to health care in the New York area, and to invest in the career development of the next generation of home health care nurses.”
Similarly, the 2024 Veterans Program funding will enhance VNS Health’s ability to support program staff in their work, increasing the program’s impact with veterans and their families across New York City’s five boroughs.
“This funding is going to help us expand all of our activities, including our direct support and advocacy for our patients who are veterans, and our partnerships with VA hospitals and other community-based resources,” notes Veterans Program Director Contessa Officer.
“The Mother Cabrini Health Foundation has provided invaluable support to our mission-driven programs over the years, for which we’re incredibly grateful,” adds Catherine Callaway, Senior Vice President for Marketing and Development. “These grants are no exception—they’ll have a lasting impact on VNS Health and the populations we serve.”
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