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Patient access leaders say the Medicare as Secondary Payer Questionnaire (MSPQ) remains a major educational challenge in their departments, despite more than half of hospital revenue potentially at stake.
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More pay, better hours, and the chance of advancement. These are the most common reasons patient access employees leave the department.
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As providers struggle with that small percentage of patients who consume the majority of healthcare dollars, theyre finding that having care coordinators who work face to face with patients often can help patients navigate the healthcare system and follow their treatment plan.
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EmblemHealths team approach to providing face-to-face care coordination after hospitalization resulted in a 31% reduction in the 30-day readmission rate for members who received the interventions when compared to a baseline group.
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In todays climate of healthcare reform and with the growing emphasis on quality, there are more opportunities for case managers than ever before.
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Keystone Mercy Health Plans Acute Care Transitions program, which embeds case managers in hospital emergency departments to work with patients who seek treatment or are hospitalized, reduced emergency department visits by 21% and hospital inpatient admissions by 32% over the course of a year among members who received interventions when compared to a control group.
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Since Tufts Health Plan launched its integrated care management model for Tufts Medicare Preferred, its Medicare Advantage plan, the Watertown, MA, health plan has seen significant reductions in hospital admissions and readmissions.