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The federally funded increase in Medicaid primary care reimbursement rates, which requires providers to be reimbursed at parity with Medicare rates in 2013 and 2014, presents states with both challenges and opportunities, according to a January 2011 brief from the Hamilton, NJ-based Center for Health Care Strategies (CHCS), Increasing Primary Care Rates, Maximizing Access and Quality.
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Adults with mental illnesses in the Cash and Counseling program had higher satisfaction, both with their quality of life and with their paid caregivers, compared to those receiving traditional Medicaid services, according to an April 2010 study done for the Substance Abuse and Mental Health Services Administration, Self-Directed Care in Mental Health: Learnings from the Cash & Counseling Demonstration Evaluation.
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To prevent hospital admissions, gather as much information as possible about the patient's discharge needs, psycho-social needs, and support systems in the community, Cory Sevin, RN, MSN, NP, director with the Institute for Healthcare Improvement advises. Talk to family members and primary care providers who know the patient and can provide first-hand information, Sevin says.
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In today's healthcare environment, as patients are being discharged from the hospital sicker and quicker than ever before, some patients are in and out of the hospital as if they are going through a revolving door, says Catherine M. Mullahy, RN, BS, CRRN, CCM, president and founder of Mullahy & Associates, a case management training and consulting company based in Huntington, NY.
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Health care professionals are familiar with the "time out" surgical teams take before beginning an operation. Teams check and validate vital information on each patent in order to prevent drastic mistakes.
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Don't say "discharge" to Hussein Michael Tahan. He prefers that you use the word "transition," as in transition planning and management.
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There are literally dozens of studies that enumerate some of the problems that plague patients as a result of imperfect transitions of care.
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WellPoint's initiatives to reduce hospital readmissions by following up with Medicare Advantage members after discharge has decreased the readmission rate and reduced skilled nursing days, according to Karen Amstutz, MD, vice president and medical director of care management for seniors and state sponsored business for the Indianapolis-headquartered health benefits company.
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By placing on-site nurse case managers in hospitals and post-acute facilities, Presbyterian Health Plan of New Mexico has saved more than $1 million in just 10 months, according to Paula Casey, MSN, RN, ONC, CCM, clinical director for inpatient and recovery services at the Albuquerque-based health plan.
