Articles Tagged With:
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Denials Categorized Based on Complexity
Some denials can be overturned easily — maybe a piece of clinical documentation is missing. Other denials are a long shot, requiring lots of time and effort to challenge. For one Philadelphia-based health system, no mountain is too high to climb.
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Revamped Tactics Needed to Overturn Surge of Denied Claims
Forced to invest significant resources trying to overturn all these denials, patient access departments are searching for the most efficient and effective way to do it.
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Start Small, Employ Relevant Personnel to Manage Complex Social Problems
Every hospital relies on a problem-solving method for performance improvement. The key is putting the right people on an intervention.
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Address Social Determinants of Health with Multidisciplinary Team, Community Partnerships
A multidisciplinary group at Zuckerberg San Francisco General Hospital has created an ED Social Medicine (EDSM) team to deliver better outcomes for patients who present to the ED and to lift some burden off the shoulders of providers. In operation since 2017, investigators are finding the EDSM team approach is delivering dividends on multiple fronts. They also believe they have created a roadmap to follow for other facilities struggling with similar concerns.
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Study Results Highlight Formerly Homeless Veterans’ Need for Case Management
Housing is an important health factor among low-income and homeless people in the community, including veterans. New research revealed that clinicians should view veterans’ housing status and their behavioral health factors, including loneliness and substance use disorder. Social workers and case managers should keep veterans’ housing and substance use struggles in mind. -
Take the First Step to Screen and Identify Patients with Diabetes and Depression
Case managers should expect a large segment of patients with diabetes also to present with depression, and possibly distress or anxiety related to diabetes. These mental health issues are common among people with the chronic illness, according to government statistics. -
Attention to Mental Health Improves Case Management for Patients with Diabetes
People with diabetes are twice as likely to experience symptoms of depression as people without the disease. New research revealed integrated treatment is effective when it improves medical and mental healthcare of patients with diabetes. Investigators found complementary and integrative health approaches can result in better patient health and satisfaction. -
A Tribute to a Case Management Pioneer: Karen Zander
In August 2020, we lost Karen Zander, one of the true pioneers in hospital case management. Karen’s name is synonymous with acute care case management. She spent a large part of her professional career advancing case management roles, models, and the measurement of case management outcomes. -
Best Practices for Amputation Recovery
Case managers make a difference in the lives of their patients, even when patients are only in the hospital briefly. This is especially true when a patient is undergoing a life-changing or traumatic event, like limb amputation. Case managers can help guide the patient on what to expect during recovery and after. In some cases, they might be the only person who can help a vulnerable patient find help for a successful and less traumatic experience.
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Caring for Homeless Adults Through Case Management
As of 2020, more than half a million people were homeless in the United States. When a case manager cares for a patient who has no home or permanent place of residence, the plan can change quickly. While the general outline of the case management process might stay the same when serving a homeless individual, there are additional items to consider.