Member Advocate Program

The Member Advocate Program is available to eligible members who were recently hospitalized and are covered under Medicare, Medicare SNP and Medi-Cal SPD only. Program services may vary depending on where members live - not all services are offered in all areas.

Benefits to Healthcare Providers

Our program has reduced hospital readmissions by 65% among eligible members who are visited at home by a Member Advocate.

Member Advocates:

Facilitate care coordination.
Provide members with important information regarding care post-discharge.
Identify red flags for readmission.
Improve communication and information-sharing between providers, care teams and hospitals.
Help members stick with their treatment plans.
Accompany members to primary and specialty care appointments.
Develop long-term relationships with members.
Encourage health-promoting behaviors.

Member Advocates also work with members who need extra help accessing care and services, and who may require additional support to improve health outcomes. This may include attending doctor appointments and promoting positive health behaviors outside the clinic setting.

The Member Advocate Program

The Member Advocate Program offers non-clinical support and services for Medicare, Medicare SNP and Medi-Cal SPD members who were recently hospitalized and need extra assistance with their healthcare. They work with providers, nurse case managers, pharmacists and other professionals involved in patient care to coordinate services and facilitate information sharing.

Members are identified as eligible based upon recent acute hospitalizations and geographic location. Through home visits with these members, our Member Advocates help to ensure they have everything they need to recover after returning home from the hospital.

If you have an eligible member who would benefit from our Member Advocate Program, email us at MemberAdvocates@regalmed.com.

Program Services

Member Advocates will visit eligible members soon after they return home from the hospital. During these home visits, the Member Advocate will:

Review discharge instructions and post-discharge appointments.
Conduct a social and environmental assessment to help identify needs such as caregiving support, fall risk reduction and food assistance.
Identify red flags that could lead to readmission.
Connect eligible members to their assigned case nurse manager and pharmacist in case they have any clinical and medication questions.
Facilitate post-discharge medication reconciliation.
Coordinate transportation to doctor appointments.

What Our Members and Physicians Say

Read what other
members are saying.

“I’ve had a wonderful experience with the Member Advocate Program. I first met my Member Advocate [Grace] when I wasn’t feeling well. Even when I didn’t want to see anyone, she was there for me. The amount of care and concern she had shown made me feel so much better. I also enjoyed receiving the care packages she would bring that had lotion to help care for my dry skin. It also included bandages and medical supplies. I cannot say enough positive things about the program. When you’re sick, you have enough to worry about. Having this lovely lady come to visit and care for me made a big difference and brought me joy.” -Josephine Flora, member

“My husband and I both thought the Member Advocate Program was a positive experience. We had no idea there was such a service offered to members. It was so nice to have our Member Advocate [Myra] come by to help us with any problems we had, such as filling a prescription or just answering our questions. It was comforting to know that someone cared. With my husband being in and out of the hospital and nursing homes for the last eight or nine years, it was refreshing that, for the first time, someone was there to come visit and check on us. We keep our member advocate’s number close by and know she is always here to help any time we need it. It gives us peace of mind.” -Mary Morstad, member

Jorge and Amada's Story

Jorge was diagnosed with congestive heart failure and required to undergo triple bypass surgery. Later, his doctors discovered that a second surgery was inevitable. The struggles he and his wife, Amada, faced as he recovered were overwhelming. When it seemed that all hope was lost, they met Member Advocate Grace. Grace immediately connected Jorge to helpful programs and services and introduced him to his nurse case manager, Maricela. Together, they made all of his doctor’s appointments, coordinated his medication plan with the pharmacist, organized home health services, and got him a much needed blood pressure monitor. The support Grace provided was instrumental in Jorge’s recovery.

“Grace’s tenacity and immediate impact saved Jorge’s life. She was amazing. My daughters
and I call her ‘Amazing Grace,’” Amada said.

If you are interested in more information about this program, click here to access our Member Advocate brochure. You can also call us at (844) 734-2563 Monday - Friday, 10:00 a.m. - 4:00 p.m. to learn more about the Member Advocate Program.
TTY users dial 711.

Member Advocate Program