Important updates

Post-Acute Complete: Turning the post-discharge window into wins

When patients leave the hospital, minutes matter. Post-Acute Complete connects care coordination, personalized clinical support, and proactive transition planning to directly improve patient outcomes and reduce unnecessary costs. It consists of several turnkey solutions that simplify complex transitions for a seamless patient and care provider experience.

Care Navigation and Wound Care Connect (WCC) are two solutions that provide tighter post-discharge follow-through, moving the needle on engagement, readmissions, utilization, and cost.

Driving better outcomes and improved coordination with Care Navigation:

Our Care Navigation program helps members manage their health journey by guiding them through the complex healthcare system and connecting them with the right services at the right time. Members are assigned to a Care Navigator who assists them with identifying appropriate community-based services, scheduling follow-ups, understanding benefits, and overcoming barriers to care—ensuring smoother transitions and better outcomes.

• More connection with fewer bounce-backs. Members enrolled in Care Navigation showed an eight-point engagement lift within 30 days post-discharge and a 16.5% reduction in observed-to-expected readmission ratio¹.
• Admissions trending down. After discharge, inpatient admits fell across settings:    -18% in medical settings, -40% in non-acute settings, and -58% for behavioral health¹.
• Meaningful cost impact. Enrolled members saw impactable savings: an 11% total cost decrease, including a 24% reduction in avoidable medical expenses¹.

Wound care, simplified

Wound Care Connect (WCC) provides enhanced services to members with complex wounds and ostomies, including timely access to wound care specialists, digital wound monitoring, and care coordination. Certified wound and ostomy nurses partner with your patients’ at-home care team to consult on optimal care pathways and closely monitor wound progression and healing.

Active WCC participants had zero wound-related inpatient admits² during participation. After discharge, wound-related ER use dropped and discharged patients consistently showed lower or comparable ER and inpatient utilization over time².

What you and your practice can expect

As members approach discharge, Carelon Care Navigators will be ready and prepared to coordinate resources to prevent readmission and identify any gaps in the discharge plan. A Care Navigator may reach out to members, their caregivers, or your facility’s discharge planner to coordinate care efforts.

To see if your patients with wounds or ostomies may qualify for Wound Care Connect, talk to the assigned Care Navigator or contact your Carelon provider services representative.

Why this matters

These results point to a simple story: when post-acute support is structured and proactive, patients stay engaged, avoid unnecessary admits, and total cost curves start to bend. Carelon’s Post-Acute Complete provides that structured support so that you can focus on what matters most: providing the best care possible to your patients.

Contact your Carelon provider services representative today to ensure your patients have access to coordinated, personalized care.

¹ Internal data, March 2022- September 2023. CTI (Care Transitions Intervention) was evaluated across 14,220 Medicare members.

² Internal WCC outcomes data, November 2022 – September 2023

Carelon MBM to introduce multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals

Carelon Medical Benefits Management (MBM) will complete roll out of multi-factor authentication (MFA) for its specialty benefits and post-acute provider portals in the next few days.

Effective September 20^th, all post-acute NexLync provider portal users will begin using our multi-factor authentication. This will be a one time roll out and will be applicable for both existing users who have not yet migrated and new users.

What is multi-factor authentication (MFA)?

Multi-factor authentication (MFA) is a multi-step login process that requires system users to enter their username and password followed by additional information such as a code sent to their email or phone. In some cases, the additional authentication step may involve answering a secret question that’s been set up ahead of logging in.  Another name that is commonly used for this type of authentication is two factor authentication or 2FA.

Why is MFA important?

Companies commonly use MFA authentication today to protect their own systems, but also to protect those using their systems. Requiring MFA helps protect all against security issues such as compromised login information and phishing attempts. A phishing attempt is an email that tries to obtain confidential information like credit card numbers, user names or passwords.

Additional information for post-acute NexLync portal users

Effective September 20th, all post-acute NexLync portal users will begin using our multi-factor authentication. This will be a one time roll out and will be applicable for both existing users and new users.

You will be automatically enrolled with the email that you used to register your portal account. Upon each sign in, users will be given the option to receive a one-time code either via their registered email or the authenticator app. Once you enter the verification code from your desired method, you should be able to access your portal account as you do today.

Carelon MBM has decided to implement this process in efforts to protect member information, our own systems and those utilizing our systems.

Please see Multi-factor authentication FAQ’s and Instructions below.
Multi-factor authentication FAQ: click here for FAQ
Multi-factor authentication instructions: click here for MFA Instructions

If you experience any issues with our MFA or need any further assistance, please reach out to the Portal Support team by completing this form here.

Provider Portal: As a reminder, our provider portal is the quickest and most efficient way to request authorization. If you have not already done so, we encourage you to sign up for the Carelon Provider Portal by clicking here.

Thank you for your continued partnership.

Carelon Post Acute Solutions
105 Westwood Place | Suite 400 | Brentwood, Tennessee 37027
Provider call center phone: 844-411-9622

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