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In these days of increasing health care costs and decreasing resources, its essential that case managers get more savvy about documenting and putting a dollar value to what theyve accomplished if theyre going to survive the inevitable budget cuts.
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The average hospital charge for treating a patient admitted for a heart attack increased by about one-third between 1993 and 2000, according to data from the Agency for Health-care Research and Quality (AHRQ).
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The move to limit the use of allergy and asthma drugs by increasing copayments, restricting access to newer drugs, and requiring preauthorization for their use may have had an adverse impact on allergy and asthma patients, according to the American College of Allergy, Asthma, and Immunology (ACAAI).
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Quality ratings for hospitals, health plans, and physicians have almost no impact on the choices consumers make, a new study by Harris Interactive has concluded.
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There is an us-vs.-them scenario that occurs in health care, and the case manager sometimes is caught in between, trying to make sure the patient gets appropriate care, says Susan Gilpin, JD, chief executive officer of the Commission for Case Management Certification in Rolling Meadows, IL.
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The 2002 version of the Case Management Society of Americas (CMSA) Standards of Practice are designed to reflect the role of the case manager in the changing health care system.
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When case managers at Highmark Blue Cross and Blue Shield talk to their members, they take steps to ensure that the members have advanced care-planning documents in place.
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Educating the internal staff was the first step in Highmark Blue Cross Blue Shields Advance Care Planning/End-of-Life Care program.
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A team approach to managing patients who are likely to be high utilizers of health care resources has paid off at HealthCare Partners, a large multispecialty medical group in Los Angeles County serving more than 450,000 patients.
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When case managers at Geisinger Health Plan get in touch with members, screening for risk of osteoporosis is a routine part of the conversation.