Hospital Case Management
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Medicaid Expansion Helped Young Adults with Traumatic Injuries
Better insurance coverage led to wider access to rehab resources, chipped away at certain racial, socioeconomic disparities.
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Best Practices for Managing Denials
When denials occur, case managers should create a plan to investigate and manage each one to determine why the claim was denied and how they can help. Using this approach, some managers have uncovered trends and root causes that can prevent future denials. It is critical for case managers to hone this skill for the benefit of the patient and the hospital. -
Improving Care for Long-Stay Patients
In a perfect world, an ill patient would recover in the hospital and return home as soon as possible. When they are medically stable and can leave the inpatient care setting, nothing is holding them back. Unfortunately, that does not always happen. Even when patients are medically ready to return home, they end up waiting in the hospital longer. A prolonged hospital stay typically is described as a stay that persists for a certain number of days (often 10 days) past the patient’s geometric length of stay. The problem of prolonged hospital stays seems to be getting worse. -
Care Coordination Approach Designed for IBD Also Could Help Others
High-risk patients with inflammatory bowel disease experience high direct costs and a substantial symptom burden. Researchers designed a care coordination-based solution to improve their symptoms and reduce care costs. The solution was cost-neutral, but helped improve patient symptom scores. -
Going Beyond the Quadruple Aim Is a Worthy Goal for Pandemic Future
The quadruple aim healthcare model continues to evolve as healthcare providers realize the importance of social determinants of health. Healthcare professionals need to develop a trusting relationship with patients, which is part of the quadruple aim’s goal of enhancing patient experience. -
Care Transitions Clinic Reduces Hospitalizations, ED Visits
The results of a recent study revealed a care transitions clinic can reduce emergency department discharge time and increase the clinic’s rate of successful transition to community primary care. Intervening within 72 hours of discharge is important for patient engagement and facilitating education about their health and care management. -
Ways for Case Managers to Cope During Trying Times
Case managers are combatting stress, compassion fatigue, and burnout on several fronts as the COVID-19 pandemic surges across many parts of the United States. They are fighting to help patients and families at a time when hospital resources are strained and care transitions are challenging. They are fighting their own grief as more patients die. They are combatting misinformation online and in person as anti-vaccine and anti-mask patients make their views loud and clear. -
Dealing with Angry Patients and Public During the Relentless Pandemic
Case managers and other providers see patients who are frustrated by long waits and the numerous, sometimes-changing infection prevention rules. The anger comes from more than just the patients who are sick with COVID-19. The pandemic has affected case management for all patients, not just those with COVID-19. -
COVID-19, Dying Patients, and Compassion Fatigue: How Can Case Managers Cope?
The delta variant wave of COVID-19 has led to signs of compassion fatigue among healthcare workers. Patients appear angrier, and the anti-vaccine misinformation is contributing to provider frustration and stress. -
The NICU/PICU Case Management Experience
While many departments and practices within the medical field might entertain a shift toward a more family-centered care model, no place exhibits this more than neonatal intensive care units and pediatric intensive care units. Care for these patients must include family, and so differs somewhat from case management in adult populations.