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As payers and providers recognize the value of care coordination for people with chronic conditions and complex care needs, opportunities are opening up for case managers in primary care practices.
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The Centers for Medicare & Medicaid Services (CMS) has started pilot testing of two more survey tools to go with the infection control pilot it began testing last year.
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The Joint Commissions Center for Transforming Healthcare has started working with 20 hospitals in South Carolina to improve their safety by examining systems, processes, and structures in an effort to minimize variability in practices.
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Hospitals that have physician offices connected to and affiliated with them now have another option for getting certified for a Primary Care Medical Home. Along with programs run by the National Committee for Quality Assurance (NCQA), The Joint Commission started offering such certification in late February.
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A study of three primary care practices that participate in Cignas Collaborative Accountable Care model, which includes care coordination for at-risk patients, showed significant cost savings and improved quality of care when compared with other practices in the same geographic area.
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Aetna started partnering with physician practices to improve outcomes by coordinating care in 2007 before the term accountable care came into use, says Randall Krakauer, MD, national medical director for Aetna Medicare.
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Since Advocate Health Care began embedding case managers in primary care offices, hospital admissions and emergency department visits have decreased and length of stay has dropped, says Sharon Rudnick, vice president of outpatient care management for the Chicago-based health system.
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Do some patient access employees make a habit of complaining about various things, yet take no action to fix the problem? Patient access leaders at St. Margarets Hospital in Spring Valley, IL, learned that some personal attention from hospital VIPs can turn this problem around.
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Wait times in registration areas are generally a huge dissatisfier, says Brenda Sauer, RN, CHAM, director of patient access at New York Presbyterian Hospital in New York City. Many times, we have patients waiting for beds because patients dont leave when we anticipate, clinical cases go longer than expected, or emergencies occur.
