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A diabetes management program that combines education, disease management, and case management has resulted in a 19% reduction in hospital admissions per thousand among members with diabetes for Blue Care Network of Michigan.
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As a result of a low-tech, high-touch case management program for women at risk for preterm delivery, preterm deliveries for ConnectiCare, a small, regional HMO based in Farmington, CT, consistently run 10% to 20% below national and regional averages.
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One of the better known ongoing collaborations in the United States is the Cambridge, MA-based Institute for Healthcare Improvements (IHI) 100,000 Lives Campaign, whose goal is to save 100,000 lives through targeted QI interventions by June 14, 2006.
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A clinical redesign project partnering social work and case management has resulted in a 15% drop in length of stay and a 66% reduction in denials during a period when the average number of cases increased by 24% at Childrens National Medical Center in Washington, DC.
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A perception gap often exists today between what health care providers say, prescribe, and advise, and what patients actually understand and carry out in their self-care. Many factors can influence this gap, including a lack of language comprehension. Yet, even when a patient is well educated, highly conversant, and appears to understand what the health care provider is saying, a perception gap can result.
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Predictive modeling is an invaluable tool in early identification of people who can benefit from case management, but using the score alone doesnt go far enough, says Kay Sherwin, RN, CCM, director of client services for Integrated Healthcare Information Services (IHCIS), a Waltham, MA-based predictive modeling and information solutions firm.
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A new, innovative medical management program by Blue Cross and Blue Shield of Illinois helps members take charge of their own health by providing interactive tools and information about health conditions, including opportunities to e-mail a nurse care advisor, personal trainer, registered dietitian, or health coach and get an answer back within one business day.
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Salaries for case management are increasing, but the vast majority of case managers are working far more than the traditional 40-hour week and are being asked to take on expanded duties that may include health coaching, utilization management, motivational interviewing, and disease management.
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A Pennsylvania hospital reports that it is seeing tremendous results from a computerized order entry system (CPOE), with an 85.7% decrease in improper doses and a 76.8% decrease in medication omissions.