Case Management Advisor
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Organization Expands Case Management for North Carolina Sickle Cell Population
North Carolina patients with sickle cell disease are a small population that experiences repeated and costly ED visits and hospitalizations. Community Care of North Carolina has 600 care managers statewide, who work primarily with Medicaid patients, matching them with 14 networks and care managers across the state.
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Orthopedic Nurse Navigator Helps Surgery Patients Stay Healthy
The Comprehensive Care for Joint Replacement program helped the University of Pittsburgh Medical Center Passavant reduce the percentage of total joint replacement patients who are discharged to a skilled nursing facility instead of home.
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Medicare Payment Codes Related to Care Management
Starting in 2017, the Centers for Medicare & Medicaid Services provided new Healthcare Common Procedure Coding System codes for care management payment.
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Designers of Collaborative Behavioral Health and Primary Care Models See Growth in Future
Recent Medicare funding for care management services, related to integrated behavioral health and primary care, has provided more incentives for healthcare organizations to use this approach.
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Study: Readmissions More Common After Observation Stays
Patients often are readmitted to the hospital after an observation stay, according to recent research which suggests hospitals may want to target this population.
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Program Offers Psychological First Aid, Support to HCWs Following Traumatic Events
When an adverse outcome occurs, support rightfully flows to the affected patients and families. However, the clinicians involved with such cases often suffer, too, and the resulting stress and anguish can lead to decreased productivity, time away from work, depression, and other serious mental health effects.
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Expert: Health Systems Should Emphasize Value-based Care Management
Since health insurers first developed case management programs in the 1980s, the marketplace for case management has evolved and changed across the continuum of care, with one possible exception: hospital settings.
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Recent CMS Payment Model Cancellations Could Affect Case Management
Case management programs could see some effects from the recent canceling of advanced care coordination through episode payment by the Centers for Medicare & Medicaid Services.
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Case Management Program Cuts Heart Failure Readmissions in Half
A case management program targeted health improvements among congestive heart failure patients and succeeded in cutting readmission rates to half the national average.
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Changes to Readmissions Rule Will Help, But No Panacea
A significant number of hospitals are set to benefit from changes in how CMS calculates penalties under the value-based Hospital Readmissions Reduction Program (HRRP), but the proposed rule won’t solve all their problems related to readmissions, says Bill Bithoney, MD, formerly CEO, CCO, and CMO at Sisters of Providence Health System in Springfield, MA, and now a managing director at BDO International consulting in New York City.