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With payers sharpening their pencils and refusing to pay for what they deem to be unnecessary hospital stays, case managers need more than ever to help their hospital balance the clinical and financial aspects of health care.
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Today's case managers need to understand outcomes and track them in order to prove that their interventions have value, says Mary Jane McKendry, RN, CCM, MBA, director of education, training, and consulting for McKesson and president-elect of the Case Management Society of New England in Hampstead, NH.
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In these times of dwindling health care reimbursement, there's no phrase more significant to managers - and their bosses - than "denial management."
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Case managers are in an excellent position to help their hospitals balance both the clinical and the financial sides of patient care, asserts Teresa C. Fugate, RN, BBA, CPHQ, CCM.
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Before the case management staff at Davis Memorial Hospital in Elkins, WV, went live with its newly designed case management plan, staff worked hard to sell the new arrangement to hospital staff and attending physicians.
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When the administration at Davis Memorial Hospital in Elkins, WV, redesigned its case management department, improving reimbursement for emergency department (ED) patients and same-day-surgery patients was a major goal.
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Frequent menstruation is a relatively new biologic state that has emerged as societies have evolved from hunting and gathering to industrialization.
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At the end of May, President Bush signed into law the United States Leadership Against HIV/AIDS, Tuberculosis, and Malaria Act, which is sweeping legislation designed to provide relief for HIV/AIDS in Africa and the Caribbean and authorizing funding of up to $15 billion over five years.
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How did this happen? asks the woman sitting in your office as you share the news from the pregnancy test. I was using birth control.
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A 13-year-old female sits in your exam room. On her initial gynecologic exam at age 12, she did not indicate that she was sexually active.