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Monthly Archives: October 2014
Blue Cross Alternative Quality Contract Lowers Costs, Improves Patient Care: Study
A Blue Cross Blue Shield of Massachusetts (Blue Cross) Alternative Quality Contract (AQC) improved quality of patient care and lowered costs in the four years since it was implemented, according to an independent study by Harvard Medical School published in … finish reading Blue Cross Alternative Quality Contract Lowers Costs, Improves Patient Care: Study
New Payment Models Reduce Reimbursement Challenges for Embedded Case Management
Understanding where a practice is and where it wants to go helps to ease the challenge of embedding case managers into physician practices, says Annette Watson, RN-BC, CCM, MBA, senior vice president of community transformation for Taconic Professional Resources. She … finish reading New Payment Models Reduce Reimbursement Challenges for Embedded Case Management
Cultural Competency Between Case Manager and Patient Breeds Engagement, Retention
Communicating with vulnerable patients effectively, whether it’s about medication non-adherence, or simply what is or isn’t working, requires a certain level of cultural competency between the case manager and patient, says Jay Hale, LPC, CEAP, director of quality improvement and … finish reading Cultural Competency Between Case Manager and Patient Breeds Engagement, Retention
Posted in affordable care act, Avoidable Hospitalization, Behavioral Health, Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, Diabetes, Disease Management, dual eligibles, Elderly Care
Tagged case management, disease management, elderly, telephonic case management
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New CMS ACO Investment Model Supports Coordinated Care for Rural, Underserved Areas
Up to $114 million in infrastructure and redesigned care processes is being invested in up to 75 eligible Accountable Care Organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP), according to the Centers for Medicare & Medicaid Services (CMS). … finish reading New CMS ACO Investment Model Supports Coordinated Care for Rural, Underserved Areas
BCBS of Illinois Specialty Intensive Medical Home Targets Most Critically Ill
Designed to improve patient access, care coordination and illness management, Blue Cross and Blue Shield of Illinois (BCBSIL) has launched the first specialty intensive medical home (IMH) program in the state with the Illinois Gastroenterology Group (IGG), the state’s largest … finish reading BCBS of Illinois Specialty Intensive Medical Home Targets Most Critically Ill
From Diabetes Management to Medical Home Recognition: The Health Coach’s Changing Role
Areas like diabetes management are not just the domain of physicians or case managers; today, health coaches often provide patients with diabetes the necessary tools and resources to manage it, says Alicia Vail, RN, a health coach at Ochsner Health … finish reading From Diabetes Management to Medical Home Recognition: The Health Coach’s Changing Role
Anthem, Hartford Healthcare Renew Value-Based Agreement; Integrate Behavioral Health, Chronic Care Programs
Anthem Blue Cross and Blue Shield and Hartford Healthcare (HHC) have renewed an accountable care agreement designed to broaden their value-based arrangement, create tighter integration and enhance care coordination, according to Hartford Healthcare officials. In addition to their current partnership, … finish reading Anthem, Hartford Healthcare Renew Value-Based Agreement; Integrate Behavioral Health, Chronic Care Programs
3 Ways Embedded Case Managers Can Support the Hospital Discharge
Ensuring that patients understand their discharge instructions and can afford their medications are two ways embedded case managers can support the hospital discharge, says Irene Zolotorofe, RN, MS, MSN, and administrative director of clinical operations at Bon Secours Health System. … finish reading 3 Ways Embedded Case Managers Can Support the Hospital Discharge
CMS Releases Data on Financial Relationships Between Healthcare Industry, Doctors, Teaching Hospitals
Designed to help consumers understand the financial relationships between healthcare industry officials, physicians and teaching hospitals, and promote transparency and accountability, CMS has released the first round of Open Payments. The program, created by the Affordable Care Act (ACA), lists … finish reading CMS Releases Data on Financial Relationships Between Healthcare Industry, Doctors, Teaching Hospitals
6 Elements of Highmark’s Pay-for-Performance ‘Best Practices’ Project
At Highmark Inc., physicians are eligible for bonus payments across a broad spectrum of measures from clinical and quality measures to prescribing habits, access to care and level of technology use. In addition, practices can also qualify for a bonus … finish reading 6 Elements of Highmark’s Pay-for-Performance ‘Best Practices’ Project
