Hospital Case Management – January 1, 2023
January 1, 2023
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Primary Care Is on Life Support, But Case Management Could Be Antidote
Primary care is facing decline due to financial factors and clinician burnout. One solution is to assign case managers or care coordinators to primary care offices to improve communication between primary care providers, hospitals, and other healthcare entities.
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Better Care Coordination Needed for Interhospital Transfers
Interhospital transfers can be challenging and frustrating for nursing staff — and sometimes dangerous and tragic for patients and their families. Health systems should pay more attention to how these transfers are handled and work to improve communication between sending and receiving hospitals.
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Possible Solutions to Poor Interhospital Transfers
Interhospital transfers can be frustrating to nurses and lead to worse outcomes for patients, research shows. But hospitals can take steps to improve the process and reduce risks for patients. The first step is to eliminate unnecessary transfers.
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Intensive Care Management Works with Complex Medicaid Population
One way to reduce costs among a population of high-cost, high-utilization Medicaid patients is to use intensive care management. In a study of an intervention involving a nonprofit organization that provides integrated care to complex patients, investigators found a reduction of more than $1,900 in total medical expense per member per month.
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ACO’s Comprehensive Patient Navigation Can Reduce Costs, Increase Satisfaction
Surprisingly, accountable care organization enrollees who are given fewer choices but better navigation assistance in making decisions are happier with their healthcare access, researchers found.
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Case Managers Can Better Educate Patients and Families About Opioid Addiction
While the world focused on the COVID-19 pandemic, another crisis — the opioid epidemic — continued to unfold, taking hundreds of thousands of lives. Hospital discharge is an opportunity for case managers and other providers to help prevent patients from becoming victims of opioid overdoses.
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Best Practices for Maternity Case Management
In many ways, case management in the maternity and labor/delivery units is unlike other areas of the hospital. Often, the mothers and babies are healthy, and simply in need of support through the process. For that reason, it may even seem that case management is unnecessary. However, it is important to maintain a strong case management department that serves in labor and delivery as well as the postpartum units.
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Understanding Bundled Payments
Bundled payments can be confusing for case managers to navigate. The philosophy behind the bundled payment reimbursement model is that in managing the patient carefully across the continuum, transitions will be smoother and the care will improve, all while staying mindful of how the dollars are spent. It is meant to be a meeting of quality of care and cost-effectiveness.
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The Role of Critical Access Hospitals
In rural areas, critical access hospitals provide care to patients who otherwise would have to travel much further for adequate care. Serving in a critical access hospital can be a much different experience than a larger hospital system, or even a hospital in an urban or suburban environment. Due to lack of training and support, even the case management process might not be as seamless or efficient as it is in other settings.