Page 65 - Total Care Guide 2018_BRD-TCG-518
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VNSNY Strategic Partnership and
              Program Development


        VNSNY Strategic Partnership and
        Program Development

        VNSNY Strategic Partnership and Program Development
        combines VNSNY services in population health, transitions
        of care and chronic disease management with new
        technology into novel solutions for providers and insurers.
        We collaborate with hospitals, physician practices, insurers,
        government agencies and technology companies to stratify
        patients and members by risk level, build care plan and
        achieve health goals such as:
        •   Avoiding hospital and emergency department admissions
        •   Medication adherence and education
        •   Assisting patients and their families in dealing with
           complex and chronic illnesses
        •   Assisting patient and their families with transitions
           of care from one setting to another

        VNSNY utilizes inter-disciplinary teams, including population
        care coordinators, advance practice nurses, social workers,
        health coaches, home health aides and behavioral, physical
        and occupational therapists who lead community-based care
        teams to provide these services for both homebound and
        non-homebound populations in and outside New York City.







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