Case Management Advisor – February 1, 2004
February 1, 2004
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Member-driven case management/disease management system pays off
When Blue Cross Blue Shield of Michigan created its proactive case management and disease management program, the Detroit-based insurer looked for every opportunity to interact with members, in addition to maximizing the traditional disease management and case management strategies. -
Seamless program handles all levels of patient care
Before Blue Cross Blue Shield of Michigan launched its BlueHealthConnection program, disease management nurses and case management nurses were in separate departments and never talked. -
Predictive modeling used for CM/DM interventions
When Blue Cross Blue Shield of Michigan decided to create a proactive case management and disease management program, the Detroit-based insurer turned to predictive modeling to identify which of its members were eligible for the BlueHealthConnection program. -
Regional offices bring CMs closer to clients
Its not unusual for members covered by Blue Cross Blue Shield of Arkansas to drop by the office and visit their case manager in person. -
Regional offices have autonomy, consistency
The regional offices of Blue Cross Blue Shield of Arkansas each have their own identity but they follow consistent policies and procedures based on URAC standards for the companys case management program. -
NICU case management pays off for health plan
A case management program dedicated to infants in the neonatal intensive care unit (NICU) has saved Blue Shield of California an average of four days length of stay off each NICU admission, saving the health plan about $3,500 a day. -
Case study of an infant needing complex care
On July 5, 2002, Baby A was born at a term gestation of 38 week by emergency cesarean due to prolonged decelerations. The infant had Apgar scores of 0/0/0 at 1/5/10 minutes, respectively, and a poor score of 4, 20 minutes after birth.