Member Advocate Program

The Member Advocate Program is available to members who are covered under Cal-MediConnect and Medi-Cal SPDs only.

Benefits to Healthcare Providers

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

Member Advocates:

  • Increase provider engagement 
  • Improve communication and information sharing between providers, care teams, and hospitals 
  • Encourage treatment adherence 
  • Facilitate care coordination 
  • Accompany members to primary and specialty care appointments 
  • Develop long-term relations with members 
  • Encourage health promoting behaviors 
  • Provide member with important information regarding care post-discharge 

The program has reduced hospital readmissions by 65% among members who are visited in the home by a Member Advocate.

The Member Advocate Program

The Member Advocate Program provides non-clinical support and services for Cal MediConnect and Medi-Cal SPD members who need extra assistance with their healthcare. Member Advocates work with members who have recently been hospitalized or at risk for hospitalization. They work with providers, nurse case managers, pharmacists, and other people involved in our members’ care to coordinate services and facilitate information sharing.

Through their visits with members, our Member Advocates help ensure that our members have everything they need to recover after returning home from the hospital. Member Advocates also work with members who need extra help accessing their care and services, and who may require additional support to optimize health outcomes. For these members, Member Advocates may also attend doctor’s appointments with them and promote other positive health behaviors outside of the clinic setting. These members are traditionally identified and referred by our nurse case managers.

We can also receive referrals from our contracted doctors for eligible members who need additional support services that will enable them to follow clinical treatment plans and reduce preventable ER visits and hospitalizations. If you believe you have a member who would benefit from this program, please contact us at: MemberAdvocates@regalmed.com

Program Services

Post-Discharge Hospital Visit

During the hospital visit, a Member Advocate will schedule a time to visit the member at home after they are discharged and explain how they can help.

Home Visits

Member Advocates visit members in their homes soon after discharge.

During the visit, the Member Advocate:

  • Reviews post-discharge instructions with the member
  • Conducts a social and environmental assessment to help identify needs such as home health and IHSS 
  • Identifies red flags that could lead to readmission
  • Connect the member to their multidisciplinary care team
  • Facilitate post-discharge medication reconciliation 
  • Coordinates transportation to doctors’ appointments

What Our Members and Physicians Say


Read what other
members are saying.

“I have not seen any IPA do what [Regal is] doing. It is really helping the primary care physicians and the patients. You care. I think that Mr. B would have ended up back in the hospital and that this program has prevented that re-admission. There has been a major improvement with him." - Ruben Casabar, M.D.

“I wish I would have known about the program sooner. My father’s quality of life has definitely improved – not just with his appearance, but also because his blood pressure and glucose have stabilized. I believe Regal has over-delivered on their promise and we are truly grateful.” - The son of Abel Becerra, Regal member

“The program definitely exceeded my expectations. I’m glad I discovered this
program, because I didn’t realize anything like this existed. The fact that they call me to check how I’m doing and if I need anything is something I will always appreciate.” - Mary Hays, Regal member

 

 

Jorge and Amada's Story

In July, 2012, 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.