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When Sharon Gauthier, RN, MSN, iRNPA, was a hospital case manager, she saw people return to the hospital over and over, with issues that might have been avoided if someone had better coordinated care in the community.
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More than 20% of U.S. adults receive periodic health examinations (PHE) each year, yet new research shows that patients who have an annual routine visit to their doctor might not receive recommended preventive screening tests and counseling services that could benefit their health.
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When Catherine M. Mullahy was a practicing case manager, she received a referral to manage the care of a patient who was recuperating at home on short-term disability, after being hospitalized with a severe case of cellulitis.
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Heart attacks in women go largely unrecognized 30 to 55% of the time, and those who miss the warning signs and fail or delay getting help, run the risk of death or grave disability.
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There's not a healthcare organization around that isn't focused on reducing unplanned readmission rates. They cost money and are the focus of a variety of regulatory and payer organizations that are either no longer paying for care related to such readmissions or will soon stop.
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Faced with an increasing number of patients who have no insurance and can't afford to pay for their own care, the University of Iowa Hospitals and Clinics in Iowa City, has developed a multi-pronged approach to identify indigent patients early in their stay and help them get access to community providers who can provide ongoing care.
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In Lee County Florida, providing healthcare for the uninsured and under insured is a community-wide effort, according to Chris Nesheim, RN, MS, CMAC, system director, case management, Lee Memorial Health system with headquarters in Ft. Myers, FL.
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At Montefiore Medical Center in the Bronx, NY, a complex care case manager coordinates appropriate post-discharge options for uninsured and under-insured patients who are likely to need complex care after discharge.
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In order to provide consistent post-acute care for uninsured or under insured patients, hospitals need to think like payers and develop a payment assistance policy so that at admission or registration, a financial counselor can do a quick assessment and determine who qualifies and who doesn't, according to Matt Boettcher, LSW, MSW, vice president for continuum of care for Scott and White Healthcare, with headquarters in Temple, TX, and consultant for the Center for Case Management, a patient care management consulting firm based in Wellesley, MA.
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In its efforts to ensure that the uninsured and homeless receive the healthcare services they need, Carondelet Health Network in Tucson, AZ, has developed a list of community resources and partnered with community agencies to provide care for patients underserved patients.
