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In a quest to meet the growing need for disease management programs to demonstrate their effectiveness, a group of industry stakeholders has come up with a set of processes that can be used to show the outcomes of disease management.
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A sophisticated technology system helps the 2,400 case managers at Intracorp coordinate the care of nearly 2 million people each year and helps the company track outcomes information.
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Its not unusual for a care manager in Horizon NJ, Healths Care Coordination Unit (CCU) to get a thank-you note or a telephone call from a member or their relative enrolled in the managed care organizations program for publicly insured members with special needs.
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As employers contract with multiple vendors to get best-in-class health care services, an employee may have a medical plan managed by a managed care organization, disease management programs handled by a number of specialty vendors, and a pharmacy plan managed by another company. Thats one of the reasons why CIGNA HealthCare began its Health Advisor Program in January as a way to assist employees and their families in navigating the health care system.
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Nearly half of all American adults 90 million people have difficulty understanding and using health information, and there is a higher rate of hospitalization and use of emergency services among patients with such limited health literacy, states a report released April 8 by the Institute of Medicine (IOM).
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People who are publicly insured need more advocacy than other populations, and the problems they face negotiating the health care system can be compounded when they dont understand the language, points out Pamela Persichilli, RNC, director of clinical operations for Horizon NJ Health, a Trenton, NJ-based managed care organization for the publicly insured.
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Competition among home health agencies for referrals can be fierce. Agency managers are increasingly concerned about employees and independent contractors who leave agencies and take patients with them.
Agencies have used a variety of strategies to combat the loss of patients to other agencies when former employees or contractors take patients with them including nonsolicitation agreements and noncompete agreements.
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More than 12% of the substantiated elder abuse cases reported involve financial or material exploitation, according to statistics compiled by the National Center on Elder Abuse. Caring for victims of exploitation after the abuser is removed requires more than just meeting their medical and daily living needs.
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Alendronate for Osteoporosis; Exercise Training in Patients with Chronic Heart Failure; Cardiovascular Prognosis of Masked Hypertension; Short-term Intensive Insulin Therapy in Newly Diagnosed DM2; Endothelial Dysfunction and Risk of Type 2 Diabetes Mellitus; Treatment of Parkinsons Disease with Pergolide and Relation to Restrictive Valvular Heart Disease.
