Case Management Advisor – August 1, 2014
August 1, 2014
View Issues
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Meet the challenge of managing care for dual eligibles
Individuals who are dually eligible for Medicare and Medicaid have complex medical and social service needs, and many also have behavioral health issues, making coordination of care a challenge. -
Team effort keeps members independent
Network Health is participating in a demonstration project that integrates Medicare and Medicaid benefits for individuals ages 21 to 64. -
Meetings help CMs meet members’ needs
WellCare Health Plans case managers meet face to face with dual eligible members and conduct an assessment that looks at the individuals living environment and social support system, as well as medical and behavioral health issues. -
CMs help multiple providers communicate
UCares care coordinators are the hub for communication among providers treating the Minneapolis health plans dual eligible members enrolled in one of two care plans depending on their age. -
Patient flow scorecards show complexity
A common refrain of ED administrators is that when it comes to patient flow, there is only so much they can do to eliminate wait times when the upper floors cannot quickly accommodate admissions from the ED. -
Patient sitters effective in reducing falls
Patient sitters are a somewhat controversial strategy for reducing patient falls, with many administrators arguing that the cost of paying someone to sit in a room and watch a patient all day cannot be justified. -
Readmitted patients more likely to die
Patients released from one hospital and readmitted to another within 30 days are more likely to die within the next month than those readmitted to the same hospital, according to a study from Canada.