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Case managers and others who work with senior citizens have a new tool to help them advise their clients on appropriate care or living decisions.
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Independence Blue Cross takes a three-pronged approach to helping members manage their health care with its newly expanded Connections SM Health Management Program.
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A comprehensive asthma management program has paid off for Care Choices HMO of Farmington Hills, MI.
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The publicly insured members covered by Horizon-Mercy often have psychological and social needs along with their medical conditions. To better serve these needs, the Trenton, NJ, health plan for the publicly insured started a social work program in May 1997.
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Involving members in goal setting and getting them to take personal responsibility for their own health are keys to the success of Harvard Pilgrim Health Cares Health Advance Care Management system, according to Liz Estabrook, RN, manager of care management for the Wellesley, MA-based health plan.
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Since Harvard Pilgrim Health Care, based in Wellesley, MA, started its Health Advance care management system to intervene with at-risk members before they require intensive medical services, the hospitalization rate for members in the program has been cut in half.
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Through a team approach that involves case managers, vocational rehabilitation counselors, and on-site job coaches, CIGNA Group Insurance has developed a successful return-to-work program for members who are severely injured or experience debilitating illnesses.
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A good working relationship between a knowledgeable and effective case manager and a cooperative, clinically up-to-date physician can result in excellent, cost-effective patient care with superior outcomes and high levels of patient satisfaction.
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Regardless of their practice setting, case managers need to take steps to maintain the confidentiality of protected health information under the Health Insurance Portability and Accountabi-lity Act (HIPAA) of 1996.