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Each year one in three adults age 65 or older suffers from a fall, often in the bathroom. Falls are the leading cause of injury death in older adults and the most common cause of nonfatal injuries and hospital admissions according to the CDC.

At LifePlans, we developed our Bathroom Safety Program because we know that many of those falls could be prevented. Additionally, the cost to prevent bathroom falls is far less than the costs to treat them.

LifePlans Bathroom Safety program is the first to establish member need for bathroom safety devices like raised toilet seats, hand-held showers, shower benches, and more, based on an objective evaluation of clinical criteria.

We leverage LifePlans National Clinical Network to conduct an in-home falls risk and bathroom safety evaluation:

  • Assessments are designed to meet Centers for Medicare and Medicaid Service (CMS) requirements
  • Key intrinsic and extrinsic risk factors are identified
  • Nurses look for medical issues that may require additional management or customer services issues that need to be resolved

After the evaluation, LifePlans creates and shares a bathroom safety service plan with specific recommendations for Medicare-covered bathroom safety devices which is shared with the member and the plan’s care management unit. Often the plan is then sent to the individual’s primary care physician. LifePlans can then order the eligible bathroom safety devices as recommended by the nurse from the Health Plan’s preferred DME vendor.

Additionally, LifePlans’ advanced communications protocols ensure those members requiring immediate clinical interventions are identified quickly for the case manager and/or physician.

LifePlans Bathroom Safety Program has been very well received by health plan members:

  • 96% would recommend the program to a friend
  • 96% would recommend that a friend join the plan in order to receive the benefit
  • 97% thought that the program will prevent future falls in their home
  • 95% felt that the benefit was valuable.

Health plans also enjoy significant benefits:

  • Member disenrollment rates declined by 42% over a six month period, which meant that each $1 invested led to “saved revenues” of $4.80.
  • Reduced claim costs for bathroom related accidents
  • Identification of high risk members needing management
  • Enhanced independence and health status of members

To find out more about how the Bathroom Safety Program can improve health and business outcomes for your health plan, please contact:

Marc Cohen
Chief Research and Development Officer