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In Cheyenne, WY, a regional medical center, a small health plan, and a community-based provider group are working together to develop an accountable care organization with the goal of reducing fragmentation, waste, and variance in care.
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Care navigators meet with EmblemHealth members at primary care practices and coordinate all their non-clinical needs.
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Like many hospitals around the country, Mercy San Juan Medical Center in Carmichael, CA, has seen a steady increase in patients presenting to the ED with mental health problems. Officials attribute the problem to dwindling resources for mental health care and, in particular, the closing of an inpatient psychiatric unit in the region in 2009. Many of the patients who previously would have been stabilized in the inpatient unit are now showing up in the ED.
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Case managers are beginning to get the recognition they deserve and National Case Management Week Oct. 12-18 is the time to celebrate all the contributions that case managers bring to the healthcare arena.
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Margaret Leonard, who recently was presented the Lifetime Achievement Award by the Case Management Society of America, points out that the Affordable Care Act and other legislation all include the concept of care coordination.
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A multidisciplinary team at CareSource, a Dayton, OH-based health plan, coordinates care for at-risk pregnant women and follows them for a year, or longer, after the birth.
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When a team of physicians, nurse practitioners, case managers, and social workers provided care for at-risk members of Priority Health health plan in their homes, emergency department visits and inpatient admissions for patients in the program dropped by 47%.
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