2011 Metrics in Healthcare Case Management

Has the practice of embedding case managers at the point of care grown since 2010? In this month’s healthcare performance benchmarks podcast, Healthcare Intelligence Network’s Melanie Matthews analyzes trends in contemporary case management and the evolving responsibilities of today’s case manager derived from HIN’s January 2011 survey results.

Toni Cesta, senior vice president of operational efficiency and capacity management at Lutheran Medical Center and Jan Van der Mei, the regional director of Sutter Health Sacramento Sierra Regions care management programs, supplement this data with commentary on the case manager’s role in their organizations.

More actionable data on case management are contained in 2012 Healthcare Benchmarks: Case Management, our new edition now available.

Length: 4:52 minutes

Reducing Avoidable ER Visits by Medicaid Patients Through Quality-Based Interventions

An Ohio collaborative of Medicaid plans is using a rapid cycle quality improvement approach to reduce avoidable ER visits by its Medicaid beneficiaries. One of the five regions targeted by the collaborative is Toledo, Ohio — known for having the highest emergency department utilization in the nation. Mina Chang, Ph.D., of the Bureau of Health Services Research for the Ohio Department of Job & Family Services, outlines the framework of the collaborative. She explains its population-based and patient-centered approach and describes some of the priority populations targeted by the collaborative’s interventions.

Dr. Chang will describe how the collaborative is developing actionable interventions to address the patient streams most likely to use the ED inappropriately during a June 23, 2011 webinar, Reducing Avoidable ER Visits by Medicaid Patients Through Quality-Based Interventions, sponsored by The Healthcare Intelligence Network.

Length: 4:27 minutes

Leveraging Population Health Management To Meet Accountable Care Organization Efficiency Metrics

As one of 10 participants in the CMS Physician Group Practice Demonstration, Dartmouth-Hitchcock has developed a competency in population health management that is being deployed in current and planned ACO pilots. Dr. Barbara Walters, Dartmouth-Hitchcock’s senior medical director, describes how the CMS demo experience provided the building blocks for an ACO, the impact of its pilots on Medicare utilization and costs, and the critical elements in managing population health in an ACO.

Dr. Walters will share how Dartmouth-Hitchcock pilots have demonstrated the value of an ACO by achieving efficiency, quality and cost targets during a June 1, 2011 webinar, Leveraging Population Health Management To Meet ACO Efficiency Metrics, sponsored by The Healthcare Intelligence Network.

Length: 3:37 minutes

Improving Medication Adherence Benchmarks Through Community Pharmacist Interventions

Training community pharmacists in the art of motivational interviewing can boost medication adherence levels in the patients who visit them, according to Janice Pringle, Ph.D, director of the program evaluation research unit at the University of Pittsburgh School of Medicine. In a unique intervention, the university is collaborating with Highmark Blue Cross Blue Shield and Rite-Aid pharmacies to deploy the training to 120 participating pharmacies to reduce medication non-adherence, a problem associated with an estimated $290 billion in avoidable medical spending every year, according to a recent New England Healthcare Institute estimate.

Dr Pringle describes the three primary reasons for medication non-adherence driving the intervention, the benefits of training the pharmacists in motivational interviewing and the pharmacy’s role in the project.

Dr. Pringle will share how patients are identified for the intervention and the tools and strategies that pharmacists are using to improve adherence benchmark levels during, Improving Medication Adherence Benchmarks Through Community Pharmacist Interventions, a May 25, 2011 webinar from the Healthcare Intelligence Network.

Length: 3:39 minutes