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Seniors covered by BlueCross BlueShield of Tennessee's Medicare Advantage plan are guided through the end-of-life processes by case managers who empower the members with the education, resources, and assistance they need to make their own decisions about what kind of what kind of care they want to receive at the end of life.
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Now that the Centers for Medicare and Medicaid Services (CMS) has issued a proposed rule that would prohibit payment for healthcare-acquired conditions for Medicaid beneficiaries, it's more important than ever that case managers work with physicians to ensure that conditions that are present on admission are clearly documented in every patient's chart, says Deborah Hale, CCS, president of Administrative Consultant Services, a health care consulting firm based in Shawnee, OK.
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When Ocean Medical Center in Brick, NJ, and Meridian At Home care agency collaborated on a remote monitoring program for heart failure patients, the readmission rate for heart failure dropped from 14.93% before the program began to 4.84% in the first eight months of the pilot program.
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As a case manager, your job involves being an advocate for your patients as well as keeping your hospital's best interest in mind. That means you need to be informed about the financial aspects of patient care.
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[Editor's note: This is the second part of a multi-part series on demonstrating the value of case management to your organization. Last month, we discussed the vast array of financial and clinical outcome measures to evaluate the effectiveness of your department as well as to demonstrate its impact on the bottom line of the organization. This month, we discuss the tremendous amount of data that can be collected and used for performance improvement, within the department and across the institution. Next month, examples of case management report cards will show how to present this data in a usable format.]
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The utilization of services by self-pay patients has increased by 6.9% over the last fiscal year at St. Joseph's Hospital and Candler Hospital, both in Savannah, GA, says Susan M. Younggreen, director of patient financial services.
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Everyone agrees that health care workers should receive the influenza vaccine each year to protect themselves and their patients.
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It is notoriously difficult to convince surgeons to change their methods and tools in the operating room to improve sharps safety. But in Tennessee, intransigence is apt to lead to a citation from the Tennessee Occupational Safety and Health Administration.
