Post-Acute Discharge Care Services

Services include:

  • Prescription Refills

  • Referrals

  • Home Care Certification and Management

  • Wound Care OVersight

  • Medical Equipment Ordering

  • Direct Access to Physician

How We Help Patients Prevent Readmissions

BridgeCare's Discharge care provides the critical care needed to help prevent unnecessary hospitalizations. We bridge the gap created by delayed follow-up. You can Thus, we serve as a "temporary" primary care office.

We can accept referrals from the  following locations: 

  • Inpatient acute care hospital

  • Inpatient psychiatric hospital

  • Inpatient Rehabilitation

  • Hospital Observation Units

 

Patients leaving the Emergency Room or Urgent care are not eligible for discharge services through BridgeCare.​

 

A broad range of services are offered to complement primary care and designed to ensure health care continuity, avoid preventable poor outcomes among at-risk populations, and promote the safe and timely transfer of patients. 

How we help with discharge care:

01

Quick Follow-Up Contact

If patients don't hear from us while they're still in inpatient care, they can expect a call within the first day or two after discharge.

03

Review of Discharge

We go over the patient's inpatient stay and make sure they understand how to make a plan for recovery.

05

Signing Orders

BridgeCare partners closely with home care to make sure patients are getting the services they need. We can also sign orders for DME (Durable Medical Equipment).

07

Weekly Follow-Ups

We offer weekly telehealth follow-up appointments to check in with patients' progress and make sure their needs are met until they establish with a primary care office long-term.

02

Appointments Within 7 Days

All our new patient appointments happen within the first seven days of discharge, which helps 'bridge' patients from hospital to home.

04

Medication Management

Our providers can adjust medications, refill prescriptions, and even oversee IV antibiotics management.

06

Patient Education

For patients with chronic conditions, BridgeCare offers health literacy coaching. Our goal is to make sure patients understand how to best advocate for themselves.

08

Patient Transition

When it's time for patients to 'graduate' from our services, we make sure they have the support they need at their new office.

Our services make a difference. The BridgeCare difference.

ACCESSIBILITY

BridgeCare offers evening and weekend appointments in addition to home and virtual visits to improve patient contact.

Artboard 2.png

APPOINTMENT TIMES

BridgeCare's typical post-hospital appointments last 60 minutes or more, face-to-face with a board-certified physician.

PATIENT SUPPORT

BridgeCare providers can help patients and their families with paperwork, FMLA, and other work notes.

form.png
Patient and Nurse
X-Ray Results

HOME CARE

BridgeCare has established relationships with most Michigan homecares and work closely to supervise and adjust home care orders. 

Artboard 2 copy.png

COVERAGE

BridgeCare accepts all major insurances including commercial, Medicaid, and Medicare.

MANAGEMENT HELP

BridgeCare contacts and advocates for patient needs within the health system and beyond.

iv.png