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Centralized Utilization Management: The Good, the Bad, and the Best Practices
Challenged with employing enough staff in case management departments, the need for expertise in every role, and the increased requirements from payers, case management leaders are evaluating centralizing utilization review. This centralization carries both benefits and challenges, some of which are amplified because of the current healthcare climate.
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Home Devices Expand Telemedicine Options
As telemedicine use increases, case management professionals can harness its benefits to improve outcomes and provide a better experience for patients and physicians. COVID-19 played a large part in the increase as providers worked to minimize exposure to the virus. However, many patients still need proper monitoring.
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Q&A: CM Leadership During Pandemic Surge
Case management leaders have been navigating another COVID-19 case surge. Angie Roberson, MSN, RN, ACM-RN, director of case management at Spartanburg Regional Healthcare System in Spartanburg, SC, works in one of the worst-hit counties in one of the worst-hit states during the late 2020 and early 2021 surge of COVID-19 that swept across the United States.
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Case Management Is Critical to Bundled Payment Programs
A healthcare organization’s Medicare Bundled Payments for Care Improvement Advanced (BCPI Advanced) program resulted in lower hospital readmission rates. The program reduced readmission rates from 30% to 19%.
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As COVID-19 Vaccine Rolls Out, Leaders Need to Roll Up Sleeves
The new COVID-19 vaccine provide good news for a pandemic-weary healthcare world, offering case managers and other hospital professionals an opportunity to become vaccinated against COVID-19. Case managers should expect uncertainty about how the first vaccines are distributed.
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Telemental Health Survey: Increased Risk of Fraud
The expansion of telehealth services brings more risk of fraud and a greater need for internal compliance programs, according to the 2020 Telemental Health Laws survey from Epstein Becker Green in Washington, DC.
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Acute, Hospital-Level Care in the Home: A Glimpse of the Future
Emergency providers can provide hospital-level acute care to patients at home under Advanced Care at Home, a new program from the Mayo Clinic that leverages technology and in-person services. The approach has been introduced in Jacksonville, FL, and Eau Claire, WI.
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Family Spirit Nurture Intervention Study Shows Benefits for the Little Ones
In an obesity prevention program targeted to Native American mothers and infants, participants reduced consumption of sugar-sweetened beverages and improved responsive feeding habits, both of which can contribute to healthier infant weights.
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Help Case Managers Overcome Vaccine Hesitancy
Many Americans and healthcare workers have doubts and skepticism about the first vaccines for COVID-19, despite the need for a rapid end to the pandemic surge that began to overflow hospitals before the December holidays. In hospitals that have mandated a COVID-19 vaccine for all staff, it is a good idea to communicate to employees why they should be vaccinated.
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New Year Starts with Challenges of COVID-19 Vaccine Rollout
As the COVID-19 vaccines are rolled out to U.S. healthcare organizations, there will be challenges in access, logistics, and maintaining infection prevention practices. The first step is determining which employees are eligible for the first phase of the vaccine rollout.