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The mission of eight onsite Medicaid case managers at WakeMed Health & Hospitals in Raleigh, NC, is to "focus only on patients who have been patients at WakeMed," says Heidi McAfee, director of patient access/case management.
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Many reimbursement dollars may be lost if patient access fails to obtain accurate information on whether a patient has another form of insurance that will supersede Medicare during the registration process.
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The use of a cardiac MRI in the observation unit at Wake Forest University Baptist Medical Center in Winston-Salem, NC, resulted in lower cost at the hospital of about $588 per patient because 79% were managed without admission, according to a study published online in the Annals of Emergency Medicine.
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Faced with an increasing number of readmissions of patients with heart failure, Integris Baptist Regional Health Center in Miami, OK, has begun a program to improve the discharge process with the goal of improving the patients' ability to care for themselves after discharge and reduce the likelihood of readmission.
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A new case management model that establishes housewide care coordination and promotes collaboration among disciplines is paying off for Alamance Regional Medical Center in Burlington, NC.
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If you're not using your patient satisfaction data to develop process improvement projects, you're missing a chance to improve patient care, says Quint Studer, CEO of Studer Group, a health care consulting firm based in Gulf Breeze, FL.
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The health care system benefits when unnecessary hospital admissions are avoided, and sometimes the best place to impact that trend is by focusing discharge services on the hospital emergency department (ED), an expert says.
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A systemwide initiative that coordinates care across the continuum for heart failure patients has reduced the 30-day readmission rate for the North Shore-LIJ health system.
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When Integris Baptist Medical Center in Oklahoma City began looking at implementing palliative care and end-of-life services, the case management department was the appropriate place to start, says Anita Bell, RN, MEd CHPN, palliative care coordinator at the 508-bed facility.
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The inpatient prospective payment system (IPPS) final rule, issued by the Centers for Medicare & Medicaid Services on July 30 makes it clear that the health care agency expects hospitals to do more with less reimbursement.