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The case management department at Lee Memorial Health System in Fort Myers, FL, has been able to demonstrate a savings of $4.5 million as a result of having case managers in the emergency department.
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If you have the emergency department volume and the staffing, covering the emergency department 24 hours a day, seven days a week is optimal, according to Joanna Malcolm, RN, CCM, BSN, consulting manager, clinical advisory services for Pershing, Yoakley & Associates in Atlanta.
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When patients are admitted to the hospital inappropriately, the paperwork involved to correct the error brings to mind the saying "an ounce of prevention is worth a pound of cure."
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Today's hospitals are facing a shrinking pool of healthcare dollars along with increased scrutiny from Medicare, Medicaid, and commercial payers and strong penalties for fraud and abuse.
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Smoothing" occupancy over the course of a week can protect patients from crowded conditions, according to a study involving 39 children's hospitals during 2007.1 Researchers compared weekday versus weekend occupancy to determine just how much "smoothing" can reduce inpatient crowding.
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In a single month, registrars at Trinity Regional Health System in Rock Island, IL, were able to obtain disability coverage for five patients with a total of $450,000 in charges, and they were able to obtain Medicaid coverage for 104 patients who had received a total of $100,000 in services.
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If a registrar complains to Kathleen Bowles, LSW, patient access supervisor at The Ohio State University Medical Center in Columbus, she begins by asking these questions: When did the incident take place? What occurred? Who was involved? What was the outcome of the situation?
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You might be seeing a decrease in your "financial buckets" of insured patients, and an increase in underinsured or uninsured patients, without a corresponding increase in the number of services rendered.
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Hospital stays for uninsured patients increased 21% between 2003 and 2008, according to a new report from the Agency for Healthcare Research and Quality (AHRQ).