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With the help of some user-friendly software and a comprehensive staff training initiative, Parrish Medical Center in Titusville, FL, has dramatically reduced its medical necessity write-offs while improving customer service.
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Case managers at Oxford Health Plans have a new set of tools to help noncompliant members in the plans diabetes disease management program.
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Coaching diabetics to make lifestyle changes, helping members overcome issues that affect their compliance, and offering classes to help patients cope with chronic disease have paid off for MVP Health Cares award-winning Diabetes Care program.
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More and more often, case managers are being called on to demonstrate their value by reporting on outcomes. But there are no hard-and-fast rules as to what outcomes to measure because they differ from organization to organization, says Mary Jane McKendry, RN, CCM, MBA, director of education, training, and consulting for McKesson Health Solutions.
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When it needed to hire nine nurse care managers for its in-house diabetes management program, Fallon Community Health Plan found a way to overcome the areas nursing shortage. It gave the nurse care managers in the diabetes program the opportunity to work flexible hours.
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A woman with diabetes who has struggled with compliance for years before getting her disease under control told Gayle McLaughlin, RN, BSN, Every time I start to go off track, I keep hearing your voice in my head.
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"EMTALA: The Essential Guide to Compliance" from Thomson American Health Consultants, publisher of Trauma Reports, explains how the changes to EMTALA will affect emergency departments and off-campus clinics.
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Emergency department physicians must be vigilant to accurately assess, rapidly stabilize, and appropriately transport a severely injured patient to the level of trauma care the patient requires. Instead of viewing missed injuries as occurrences that result from inexperience or incompetence, strategies to minimize the occurrence of missed injuries and the resulting consequences are needed. All aspects of a trauma system must work together to improve patient care.
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When I was a resident in obstetrics and gynecology in the mid-1970s, and well beyond, the dogma was that any ovarian cyst or mass in a postmenopausal woman was abnormal and required surgical resection.