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Expectations are key to having a good working relationship with legal counsel, says Pamela L. Popp, MA, JD, FASHRM, CPHRM, vice president for health care practice with McQueary Henry in Dallas, which provides insurance products and risk management services.
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Continuing the effort to eliminate what it calls an entirely preventable class of error, the Joint Commission has updated its frequently asked questions on how to avoid performing a procedure on the wrong body part, wrong person, or the wrong procedure on the right patient.
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This case highlights a breakdown in procedure in caring for a woman injured in an automobile accident.
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People who are publicly insured need more advocacy than other populations, and the problems they face negotiating the health care system can be compounded when they dont understand the language, points out Pamela Persichilli, RNC, director of clinical operations for Horizon NJ Health, a Trenton, NJ-based managed care organization for the publicly insured.
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Nearly half of all American adults 90 million people have difficulty understanding and using health information, and there is a higher rate of hospitalization and use of emergency services among patients with such limited health literacy, states a report released April 8 by the Institute of Medicine (IOM).
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As employers contract with multiple vendors to get best-in-class health care services, an employee may have a medical plan managed by a managed care organization, disease management programs handled by a number of specialty vendors, and a pharmacy plan managed by another company. Thats one of the reasons why CIGNA HealthCare began its Health Advisor Program in January as a way to assist employees and their families in navigating the health care system.
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Its not unusual for a care manager in Horizon NJ, Healths Care Coordination Unit (CCU) to get a thank-you note or a telephone call from a member or their relative enrolled in the managed care organizations program for publicly insured members with special needs.
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A sophisticated technology system helps the 2,400 case managers at Intracorp coordinate the care of nearly 2 million people each year and helps the company track outcomes information.
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In a quest to meet the growing need for disease management programs to demonstrate their effectiveness, a group of industry stakeholders has come up with a set of processes that can be used to show the outcomes of disease management.