Medical Companion Program
Last updated
Share PrintThe Medical Companion Program seeks to provide caregiver services in lieu of hospitalization to those Veterans who do not have a responsible adult available. By doing so, it provides increased access to care by addressing a psychosocial barrier while at the same time, demonstrating a significant cost savings to the government.
Origin:
June 2019, Edward Hines Junior Hospital
Adoptions:
1 in-progress, 1 unsuccessful
Partners:
Care Management and Social Work Services, Community Engagement, Hospital Medicine
Recent Updates
Overview
The problem
Per VA regulations, all Veterans who undergo outpatient or ambulatory procedures using sedation and/or anesthesia are required to have a responsible adult accompany them to the procedure in order to facilitate their recovery and transition from a VA medical facility to their desired destination post care. For those Veterans who do not have a responsible adu
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Per VA regulations, all Veterans who undergo outpatient or ambulatory procedures using sedation and/or anesthesia are required to have a responsible adult accompany them to the procedure in order to facilitate their recovery and transition from a VA medical facility to their desired destination post care. For those Veterans who do not have a responsible adult available, these procedures are at times cancelled, postponed, or the Veteran is offered admission into an observation unit that is otherwise, not clinically indicated. The Medical Companion Program facilitates time limited, VA paid, medical companion services in which the companion accompanies a Veteran during transport, throughout the Veteran's procedure at the main VAMC campus, and at the discharge location for a time period as clinically ordered. Initial goals included enhancing access to care, eliminating psychosocial barriers that pose barriers to Veterans obtaining their clinically indicated procedures, and doing so in the most cost-efficient way to the government.
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The solution
In FY 2019, a piloted Medical Companion Program was launched utilizing an investment from the VHA Innovators Network. As a result of the pilot's success, a local Medical Companion Program was launched in February 2020.
The results
FY 2021 was the first full fiscal year that our facility had an operational medical companion program. As a result, 150 Veterans were successfully able to complete their procedures in the outpatient setting. Comparatively, only 14 Veterans required admission into an observation unit to facilitate their outpatient procedures.
Files
- FY 2021 data review Medical Companion Program FY 2021 Data
- Preliminary data for FY 2022 Medical Companion Program FY 2022 Preliminary Data
Metrics
- Number of Veterans who utilized MCP services to facilitate their outpatient procedures (FY 21)-150
- Cost savings to the government (FY 21): $395,000.00
- Average reduction in average Veteran cost (FY 21): 88%
- Number of Veterans who utilized MCP services to facilitate their outpatient procedures (FY 22 Quarters 1&2): 102
- Cost savings to the government (FY 22 Quarters 1&2): $265,000.00
- Average reduction in average Veteran cost ( FY 22 Quarters 1&2): 86%
- Program cost (FY 21): $55,227.00
- Program costs (FY 22 Quarters 1&2): $$41,322.00
Diffusion tracker
Does not include Clinical Resource Hubs (CRH)
Implementation
Timeline
-
2 weeks
Identification of a funding source and allocating funds accordingly (disclaimer--this step would be necessary absent any national directive allocating a funding source) -
2 weeks
Identify team members that will work together to implement the practice (to include, but not limited to: Social work, Utilization Management, Fiscal Service (if necessary), Office of Community Care (if necessary), Contracting representative (if necessary), Medicine Service, Surgery Service) -
1-3 months
Identify/onboard a MCP Coordinator (recommend a .5 FTE) -
1 month
Administrative tasks--develop a referral mechanism, tracking mechanism, data collection tool, SOP (absent national directive that supersedes the need), Fact Sheet, etc.. -
2 weeks
Staff education--educate staff and personnel about the Medical Companion Program, who might be eligible for the program, how to submit a referral, etc..
Departments
- Social work
- Gastroenterology
- Administration
- Internal medicine
- Outpatient surgery
Core Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
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PROCESSES |
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TOOLS |
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Support Resources
| Resource type | Resource description |
|---|---|
PEOPLE |
|
Risks and mitigations
| Risk | Mitigation |
|---|---|
| Unknown national support for the Medical Companion Program | Implementing a team approach and soliciting support on the local level to operate a Medical Companion Program while at the same time, elevating the program through national initiatives when the opportunity is present. |
Contact
Comment
Comments and replies are disabled for retired innovations and non-VA users.
Email stephanie.sawin@va.gov with questions about this innovation.
About
Origin story
In the spirit of VA's mission focused mindset, in FY 2018, Hines VA had to pursue unwarranted admission under an inpatient observation status for 149 Veterans so that they could have their outpatient procedures performed. An overnight observation stay cost the facility a minimum of $3000.00 per night (not including auxiliary expenses) therefore the facility
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In the spirit of VA's mission focused mindset, in FY 2018, Hines VA had to pursue unwarranted admission under an inpatient observation status for 149 Veterans so that they could have their outpatient procedures performed. An overnight observation stay cost the facility a minimum of $3000.00 per night (not including auxiliary expenses) therefore the facility had spent well over $447,000.00 in unwarranted admissions in FY 2018. This was simply not a sustainable solution for our facility and therefore, staff began reviewing alternative options where it was then discovered that community home health agencies can and do offer companionship services for same day surgical procedures as part of their everyday business operations.
Original team
Stephanie Sawin
Social Worker and Medical Companion Program Coordinator
Jeanne Obrochta
Social Work Clinical Manager
Joseph Ader
Social Work Executive
Brad Hagen
Accounting Officer
Deborah Daniels
Utilization Management
Jualia Sims
Office of Community Care
Dr Sandy Reynertson
Acting Chief of Medicine
As a GI nurse navigator our team helped roll out this innovation ate our facility. (Jennifer Moreno Department of Veterans Affairs Medical Center 3350 La Jolla Village Drive San Diego, CA 92161)
We have been utilizing the medical companion program for about 2-3 years now.
Please add us to the Successful adoptions list !
Starting to think about how we can implement at the Washington, DC VA
Awesome! Would be so happy to chat with you about it if that would be helpful. If interested, feel free to shoot me a message and we can set something up!