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In todays climate of healthcare reform and with the growing emphasis on quality, there are more opportunities for case managers than ever before.
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Keystone Mercy Health Plans Acute Care Transitions program, which embeds case managers in hospital emergency departments to work with patients who seek treatment or are hospitalized, reduced emergency department visits by 21% and hospital inpatient admissions by 32% over the course of a year among members who received interventions when compared to a control group.
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Since Tufts Health Plan launched its integrated care management model for Tufts Medicare Preferred, its Medicare Advantage plan, the Watertown, MA, health plan has seen significant reductions in hospital admissions and readmissions.
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While studies show that most people come to the ED because of an urgent or emergent medical concern, some people wind up in an emergency setting because they are not plugged in to the kind of social or medical resources that could more appropriately meet their needs.
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Shift changes are a point of risk in hospital settings because as outgoing clinicians hand off patients to incoming staff, it is easy for important information to be missed or misunderstood. And this risk is heightened in the emergency setting, where providers are working under a constant state of urgency.
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Although all of them qualify for a skilled nursing level of care, 86% of participants in Summit ElderCare are able to live in the community.
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Senior citizens are just like everyone else: They prefer living in their own homes where they feel secure and can do as they please, when they please, instead of being in an institution where they are at the mercy of the facility's routine.
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Telemedicine has been used to connect patients in rural areas with providers, and to obtain quick access to a neurologist when patients present with symptoms of stroke.
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Women with gestational diabetes who received telephone-based management from a nurse had a lower risk of high birth weight for newborns in a study conducted by the Kaiser Permanente Northern California Division of Research.
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Patients who participate in Hospital Sisters Health System Medical Groups Nurse Navigator Program have shown significantly fewer emergency department visits and hospital visits as well as better control of their chronic conditions than patients who are not being followed by a nurse navigator.
