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After Summa Health System and Akron, OH, area nursing facilities formed the Care Coordination Network to improve communication throughout the continuum of care, lengths of stay and readmissions for patients transferred to facilities in the network dropped.
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A pilot project providing coaching and follow up for heart failure (HF) patients who are readmitted frequently resulted in a 50% drop in the readmission rate at Indiana University (IU) Health Ball Memorial Hospital in Muncie, IN.
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The recruitment and retention of good case managers has never been more important than it is today. In the early years of hospital case management, many case managers transitioned into the role from utilization review or discharge planning positions.
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Where will we find the new case managers and what will the new candidate look like? They might not be the seasoned clinician as you would hope for. As we need more and more case managers and social workers, some of us might need to look even more broadly for our candidates.
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At Pennsylvania State University (Penn State) Milton S. Hershey Medical Center in Hershey, PA, a long-term acute care liaison evaluates patients with complex needs for potential placement in a long-term acute care hospital (LTACH), coordinates a comprehensive plan for transition with the treatment team, and works with the accepting facility and the patients' insurers to ensure a smooth transition.
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If recent state efforts to reform Medicaid, including Rhode Island's and Texas's, prove to be successful, we are likely to see similar approaches in other states, says Elizabeth Weeks Leonard, JD, associate professor of law at the University of Georgia in Athens.
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Ohio Medicaid got by with policy changes and rate reductions for the past two years, says Medicaid director John McCarthy, but future efforts are going to focus on better management of high-cost clients, including dual eligibles.
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Alabama Medicaid hasn't made any changes to its copays, which are $3 for outpatient hospital visits and exempted for emergencies, nursing home patients, pregnant women, children or patients receiving family planning services, and doesn't intend to do so, according to the state's Medicaid medical director, Robert Moon, MD.
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Family planning services have a special status under Medicaid, notes Judith Solomon, co-director of Health Policy at the Center on Budget and Policy Priorities in Washington, DC.
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Sixty percent of the 900,000 Oklahomans who were provided healthcare in fiscal year 2010 by the Oklahoma Health Care Authority received care from the SoonerCare Choice program, which transitioned to a Patient Centered Medical Home (PCMH) model in January 2009.
