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We’re expanding our home telemonitoring program for eligible Medicare Advantage members with congestive heart failure diagnoses. As of November 1, 2019, the home health care providers listed below will join the program and can accept referrals.
Home Health Foundation (member of Wellforce), which includes:
See below for a full list of all home health care providers participating in this pilot program.
Telemonitoring gives the member’s physician important information about their daily vital signs. It also can be used as a tool to educate the member on good nutrition, symptom management, and self-care for their condition.
This program helps members self-manage their condition and may keep them out of the hospital or reduce readmission rates.
Medicare Advantage members may be eligible to receive this service through their home health care benefit. They do not need to be homebound to participate. In addition, the member must:
There’s no additional cost to the member if they meet the program criteria.
Once we identify a member (or receive a referral from the member’s provider), Blue Cross Blue Shield of Massachusetts works with the home health care provider.
The home health care provider will contact the member’s primary care provider to get an order for the services and the acceptable ranges for monitored vital signs.
Then, the home health care provider goes to the member’s home to complete an initial assessment. During their in-home visit, the registered nurse will assess whether the member is physically and cognitively appropriate for telemonitoring and provide any educational needs they may have. The registered nurse can also assess other unmet needs, such as meals and transportation, and suggest resources.
If the member meets assessment criteria, the nurse will install the equipment and show the member how to use it.
Telemonitoring typically lasts six to eight weeks. When the member is discharged, the primary care provider is notified with a detailed discharge summary. If applicable, Blue Cross case managers will continue to follow the member by phone with periodic check-ins.
Participating providers | Contact for referrals |
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BAYADA Home Health Care |
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VNA Care—VNA Care Network & VNA of Boston |
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Home Health Foundation, a member of Wellforce, including:
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These providers have a single contact for referrals | |
Brockton VNA brocktonvna.org |
Visiting Nurse Associations of New England, Inc. (VNANE)
Visiting Nurse Associations of New England, Inc. will contact us about your referral. |
Community Nurse Home Care, Inc. communitynurse.com |
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Community Visiting Nurse Agency, Inc. communityvna.com |
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GVNA HealthCare gvnahealthcare.org |
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Natick Walpole Visiting Nurse Association, Inc. nwvna.org |
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Norwell Visiting Nurse Association, Inc. nvna.org |
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Porchlight VNA/Home Care porchlighthomecare.org |
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Visiting Nurse Community Health, Inc. thevisitingnurses.com |
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VNA of Southern Worcester Co., Inc. vnaswc.org |
For questions about Blue Cross Blue Shield of Massachusetts’ program, call Tarcia Davis, RN, BSN, CCM, program manager in our case management department, at 1-617-246-4269.
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