-
The multi-million dollar award against the Tuomey Healthcare system holds important lessons regarding a hospital's business relationship with physicians performing outpatient surgery. The case involved allegations of improper referrals and payment to physicians.
-
-
Clinicians concerned about bleeding and other complications
-
At the University of Michigan Health System, complex case managers coordinate inpatient and outpatient treatment and psychosocial services for patients who frequently visit the emergency department or are hospitalized.
-
Carondelet Health Network in Tucson, AZ, places community health outreach workers in the emergency department to help patients who use the ED for non-emergent conditions find a primary care provider.
-
Care managers embedded in primary care clinics work with patients with high-risk diagnoses and multiple visits to the emergency department or hospital.
-
MetroHealth Medical Center in Cleveland has partnered with two health plans to provide intensive care coordination for high-cost patients with multiple medical problems and, often, behavioral health issues.
-
Every hospital has patients it sees over and over, often for preventable conditions or problems that could be treated in a lower level of care. According to the Agency for Healthcare Research and Quality, the top 1% of healthcare users account for 21.4% of healthcare expenditures. In this issue of Hospital Case Management, we'll show you what case managers are doing to help patients avoid unnecessary hospital visits and to seek treatment in an appropriate level of care. You'll learn how one hospital's "red carpet treatment" has cut hospital visits among super utilizers, how embedded case managers target high utilizers, and how dealing with social issues helps keep patients out of the hospital. We'll describe a community approach to mental health transitions and a program to help emergency department patients navigate the health system.
-
In order to improve transitions between levels of care, CareOregon has developed several initiatives to ensure that members get what they need after discharge.
-
Gaps in care and miscommunication may occur when patients move between levels of care, sometimes resulting in adverse outcomes.