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As payers and providers grapple with ways to ensure that people obtain the healthcare services they need to stay healthy and to keep rising costs down, it's a good time to be a case manager.
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When Jan T. Homan, RN, BSN, was a home health nurse, she encountered several "revolving door" patients who would receive home health services for six weeks, keep their chronic condition under control for a few months, then end up back in the hospital and be discharged again with home health services.
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An iPhone app that measures the user's heart rate is not only a popular feature with consumers, but it sparked an idea for a researcher at Worcester Polytechnic Institute (WPI), in Worcester, MA, who is now turning smart phones, and eventually tablet devices, into sophisticated medical monitors able to capture and transmit vital physiological data.
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The key to managing the care of a multicultural population is to understand the people with whom you are working and to be aware of the challenges they face, says Sherry Rumbaugh, RN, director of care coordination for Passport Health Plan, a Medicaid health plan with headquarters in Louisville, KY.
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The ED at Sinai Hospital of Baltimore sees a fair number of patients who frequent the facility for primary care, mental health needs, and other services that emergency providers are not ideally suited to provide.
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Horizon Blue Cross Blue Shield of New Jersey members who received care at patient-centered physician practices were able to avoid more than 1,200 emergency department visits and 260 inpatient admissions, which represents a savings of approximately $4.5 million.
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New opportunities are opening up for case managers in primary care as physician practices, healthcare systems, and health plans recognize the value of care coordination.