Talk to any insurance adjuster who works in the Michigan no-fault system and they will tell you that they have an obligation to combine quality service identification with cost effectiveness. So many of the 1200+ persons injured in Michigan auto accidents each year require extensive rehabilitation, recovery time, special housing and more that has to be paid under their Personal Injury Protection, (PIP) benefits as part of their auto no-fault policies.
Those with serious medical trauma end up housed and cared for in skilled nursing centers or at home with 24-hour nursing, especially those with ventilators. The push, however, more often than not is to minimize the cost of care by utilizing a facility instead of paying for 24-hour nursing in an injured party’s private home. Some case managers, families and injured parties push back but its a battle not always won.
Where comprehensive adult day programs come in is how inexpensively yet effectively they can provide rehabilitative and monitoring services for those with traumatic injury and cognitive deficit. Life in a daily, well-managed day services program averages $100.00 per day nationally, far less than what it would cost to arrange attendant care by nurses in a private home.
It is also significantly less expensive than life in a skilled nursing center. Using adult day services in combination with life at home can provide real care along the continuum, blending the services of an adult day program with life at home. This is often a winning combination for many injured parties.
Yet of the seven, (7) claims adjusters interviewed before this Blog Post was written, each indicates not one, (1) adult day program of a clinical nature has reached out to them or their superiors and five, (5) indicate they have never been inside of one. As the adult day care community seeks heightened relevance and a place at the table as providers of rehabilitative services the time has come to educate your public about how complex and far-reaching you can be.
If this does not occur, the relationship between those who manage PIP benefits and the adult day care community could evaporate to no end.
Penny for your thoughts.
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