Articles Tagged With:
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Organization Expands Case Management for North Carolina Sickle Cell Population
North Carolina patients with sickle cell disease are a small population that experiences repeated and costly ED visits and hospitalizations. Community Care of North Carolina has 600 care managers statewide, who work primarily with Medicaid patients, matching them with 14 networks and care managers across the state.
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Orthopedic Nurse Navigator Helps Surgery Patients Stay Healthy
The Comprehensive Care for Joint Replacement program helped the University of Pittsburgh Medical Center Passavant reduce the percentage of total joint replacement patients who are discharged to a skilled nursing facility instead of home.
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Medicare Payment Codes Related to Care Management
Starting in 2017, the Centers for Medicare & Medicaid Services provided new Healthcare Common Procedure Coding System codes for care management payment.
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Designers of Collaborative Behavioral Health and Primary Care Models See Growth in Future
Recent Medicare funding for care management services, related to integrated behavioral health and primary care, has provided more incentives for healthcare organizations to use this approach.
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Liability Protections for EMTALA Care Elusive for EPs
Although several states have enacted liability reform legislation for ED care, efforts at the federal level have been less successful. Here is a summary of legislation under consideration in Congress.
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Visit Volume Linked to Being Named in Claim
One in 11 EPs was named in malpractice claims during a 4.5 year period, according to a recent study. Total number of years in practice and visit volume were the only factors associated with being named as a defendant.
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When Psychiatric Patient Comes to ED, Consider Entire Hospital’s Capabilities
An attorney who worked on the case provides detailed information about a recent record-breaking EMTALA settlement.
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Inspector General Sets Sights on ED Psychiatric Boarding Practices
Psychiatric patients are held routinely in EDs for hours, days, or even weeks due to lack of available facilities. Few would argue it’s a high-risk situation for the patient, EPs, and the hospital; yet, the dangerous practice continues.
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Non-prudent Limits on Patient Visits: Overcoming Barriers to Provide Necessary Care
Since EMTALA requires medical professionals to provide care to their patients, big insurance companies see no reason to provide payment for care they do not feel like covering. While some argue that on the surface this is their right to pay only for necessary services, the decision to retrospectively deny coverage is a fundamental assault on the rights of patients to seek emergency care and providers to bill for legitimate services rendered. Using the “retrospectoscope” to lecture patients and providers about care for serious health threats is a disservice to all medical professionals. It is unconscionable, immoral, illegal, and potentially unconstitutional.
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Clinical Briefs
In this section: A better definition for celiac disease; shedding light on a vaccine; and treating asthma.