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If youre a typical case manager, you are faced with ethical dilemmas several times a day. The job is pressure-filled. Case managers are under pressure from insurers to contain costs, from employers to return people to work.
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When youre confronted with an issue that just doesnt feel right, ask yourself: Am I truly doing the right thing at the right time for the right reason?
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When it comes to confidentiality issues, case managers often walk a tightrope, Mindy Owen, RN, CRRN, CCM, asserts.
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Before Trenton, NJ-based Horizon/Mercy started its Childrens Health Assessment, Maintenance, and Preventative Services (CHAMPS) program for publicly insured mothers with infants, many of the mothers didnt realize the importance of getting immunizations and well-child visits for their children, says Giavanna Ernandes, RN, MSN, APNC, team leader for disease management, including the CHAMPS program.
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When Horizon/Mercy compiled the six-month outcomes report for its program to reduce the level of lead in its young members blood, the figures were so astonishing that the state epidemiologist monitoring the program checked them himself.
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BlueHealthConnections, a care management program in use at Blue Cross Blue Shield of Michigan in Detroit, pulls together a lot of care management programs that have been in place for many years.
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Before Blue Cross Blue Shield of Michigan developed its BlueHealthConnection representatives of almost every department in the company spent considerable time deciding exactly how to integrate all of the Detroit-based insurers patient care services.
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Kaiser Permanente, one of the countrys largest integrated health care organizations, has developed guidelines for incorporating depression management into its disease management programs.
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Health benefits are declining for Americans for the first time since 1993, according to the Employee Benefit Research Institute (EBRI).
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Musculoskeletal conditions, including arthritis, low back pain, repetitive motion strain, and mental health problems, mostly depression, have the biggest negative impact on worker productivity, according to a new survey by the Institute for Health and Productivity Management (IHPM), a nonprofit research organization with headquarters in Scottsdale, AZ.
