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Healthcare organizations in a variety of settings are leveraging today's technology to increase the efficiency of case managers and nurses and for early intervention of patients who are experiencing exacerbation of their disease or other problems that might lead to an emergency department visit or hospitalization.
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UPMC Health Plan in Pittsburgh, PA, takes a three-pronged approach to reducing unnecessary emergency department visits that includes outreach calls from care managers, stationing a patient navigator in an emergency department that serves a large UPMC population, and home visits by a nurse/social worker team for patients who need extra help in managing their healthcare.
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Mental health experts believe that as with many acute medical conditions such as stroke and heart attack, early diagnosis and treatment can make a critical difference for patients with schizophrenia, potentially limiting the severity and progression of the disease.
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By meeting their clients face-to-face and building relationships, case managers at the Mental Health Association of Westchester County, NY, are able to help adults and children working through mental illness or emotional distress access the kind of help they need to stabilize their conditions, says Amy Kohn, PhD, chief executive officer of the private not-for-profit mental health multi-service organization in Tarrytown, NY.
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When members of Passport Health Plan use the emergency department for non-urgent conditions, the health plan calls them to find out why they chose that level of care.
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Faced with an increase in patients who seek care in the emergency departments for non-urgent conditions, health plans are looking for ways to reduce unnecessary visits to the emergency department and steer patients to more appropriate levels of care.
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Hospitals that receive federal funds are required by law to offer language assistance to patients with limited English proficiency (LEP).
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When members in UPMC Health Plan's Special Needs Plan are experiencing excessive hospital admissions and/or emergency department visits, the health plan sends a team of social workers and nurses to their homes to assess the members' healthcare and psychosocial needs and get them the resources they need to stabilize their conditions.
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When Valley Baptist Medical Center in Brownsville, TX, began a project to reduce readmissions in the fall of 2009, the overall 30-day readmissions rate was 23.3%.