A new model of assistance: the first insurance experience of LTC care model

presenter(s) Vanessa Sabbi | UniSalute, UnipolSai Group


ABSTRACT

In Italy, the National Health System (NHS) lacks sufficient resources and organization to adequately supervise home healthcare. UniSalute insurance specializes in health group policies and has created a process that allows customers to find, evaluate, organize, inform in case of LTC PROCESS ACTOR: -customers -case manager -central operational assistance H24 7/7 -Unisalute network of partner for health and other services, including social needs –NHS PROCESS SYNTHESIS PHASES -Find a professional to manage, organize, and assess medical care needs: case manager (CM) - Select a validated instrument and acknowledged for the multidimensional assessment of the person at home (InterRaiHC) -share the care plan with the client and family -build a network of 66 suppliers nationwide with discounted rates to provide services, support, social according to the needs identified by the CM -integrate the NHS where deficient -provide a 24H service through the central assistance to support the customer and arranges care as directed by the CM according to the customer One of the fundamental problems in Italy is the fragmentation of services and the heterogeneity of the performance, in fact the directions of the government are declined at the regional and municipal level in a personalized way for the same service, the person must follow the bureaucratic procedures with several different forms depending on the province in which he lives. Another fundamental problem is the assessment of Long Term Care as every Italian region has adopted its own system, this results in economic losses, professional and considerable discomfort for the sick person and his family who are forced to turn to different offices presenting multiple documents and in consultation with many professionals who do not communicate with one another. Unisalute wants to represent the new organizational model, unique in Italy, for the management of dependent persons at home by a private insurance that aims to improve care, standardize services, reduce costs and make the customer the actor main process of taking charge of the organization and support it. The new model of private care management UniSalute individualizes patient care and efficiency in health care delivery by identifying and prioritizing patient medical needs, matching these needs with up to date information on the network of services offered by NHS, and guiding the patient to the best services available in the system to address their medical needs, thereby improving efficiency and complementing the performance of the network of suppliers working with UnisalutE Outcomes • personalized assistance and rationalized service • case manager supervision • discounted rates with a network of proven suppliers • organization of services directly by the central assistance • the customer is informed of all the services that are available to it and that can be provided by the NHS.


date 2 September 2014



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