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The last place patients want to end up after a hospital stay is right back in the hospital.
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A proactive approach to hospital readmissions by Health Alliance Plan (HAP) resulted in a 14% decline in readmissions for heart failure in the Medicare population when compared to the previous year.
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In a study reported online by the American Journal of Cardiology, Henry J. Michtalik, MD, MPH, and his colleagues tested heart failure patients on admission and discharge for levels of a protein that's considered a marker for heart stress.
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A program that provides face-to-face case management and hormone injection services for women at risk for pre-term birth has reduced the spontaneous pre-term birth rate by 8% among the Medicaid population served by the program.
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When patients don't follow their discharge plan and end up back in the hospital or fail to keep their chronic disease under control, resulting in complications, it could be that they simply don't understand what they're expected to do.
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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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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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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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[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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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.