Category Archives: Case Managers

Cigna Collaborative Care Reduced Avoidable ER Visits by 16 Percent

Cigna’s second-year results from a collaborative care initiative with Granite Healthcare Network (GHN) reveals significant progress in improved health and affordability, and decreased avoidable emergency room (ER) visits by 16 percent, according to Cigna officials. Cigna Collaborative Care, a partnership … finish reading Cigna Collaborative Care Reduced Avoidable ER Visits by 16 Percent

Posted in Accountable Care Organizations, affordable care act, Care Coordination, Case Managers, Case Managers and the Patient Experience, Diabetes, Disease Management, Elderly Care, electronic health records (EHRs), Emergency Room, Hospital Readmissions, Reducing Healthcare Costs | Tagged , , , , | Leave a comment

Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

Preliminary findings from two advanced primary care initiatives from CMS show decreased hospital admissions and emergency department (ED) visits, CMS officials report. The two large-scale tests of advanced primary care—the Comprehensive Primary Care (CPC) initiative and the Multi-Payer Advanced Primary … finish reading Advanced Primary Care Initiatives Reduce Hospital Admissions, ED Visits: CMS

Posted in Accountable Care Organizations, affordable care act, Avoidable Hospitalization, Care Coordination, Case Managers, Healthcare Reform, Healthcare Spending, Physician Organizations, Population Health Management | Tagged , , , , | Leave a comment

Pilot Prevents Unnecessary Hospitalizations by Optimizing Transfers of Nursing Facility Residents

Designed to prevent unnecessary hospitalizations of nursing facility patients, a new study focuses on how to optimize transfers of these patients between facilities and acute-care institutions by improving care and communication, according to research from Indiana University (IU) and Regenstrief … finish reading Pilot Prevents Unnecessary Hospitalizations by Optimizing Transfers of Nursing Facility Residents

Posted in Avoidable Hospitalization, Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, Disease Management, Elderly Care, Hospital Readmissions, Hospital Services, Hospital Training, Improving Patient Care | Tagged , , , | Leave a comment

5 Embedded Case Management Strategies for 30-Day Readmissions Success

Looking to ward off Medicare 30-day readmissions penalties, Caldwell Memorial Hospital managed to decrease rehospitalizations from over 19 percent to less than 10 percent, a metric that catapaulted their hospital’s readmission ranking into the top five nationwide, says Melanie Fox … finish reading 5 Embedded Case Management Strategies for 30-Day Readmissions Success

Posted in Care Coordination, Case Managers, Embedded Case Manager, Hospital Readmissions | Tagged , , , | Leave a comment

Trinity Health-Heritage Population Health Partnership Designed to Upgrade Primary Care Models

Trinity Health and Heritage Provider Network (HPN) have formed a joint venture set to redesign existing healthcare models, including primary care, care management, hospitalist, post-acute care and high-risk clinics, in order to improve and coordinate care, according to Trinity Health. … finish reading Trinity Health-Heritage Population Health Partnership Designed to Upgrade Primary Care Models

Posted in Accountable Care Organizations, affordable care act, Care Coordination, Case Managers, Clinical Integration, Comprehensive Primary Care Programs, Disease Management, Population Health Management | Tagged , , , , , | Leave a comment

Health Plans Foster Population Health with Care Coordination, Case Management

As population health management (PHM) finds its footing in value-based healthcare, PHM program focus, support tools and key players continue to shift, according to 129 respondents who participated in the latest Population Health Management Survey conducted in June 2014 by … finish reading Health Plans Foster Population Health with Care Coordination, Case Management

Posted in affordable care act, Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, Disease Management, Population Health Management | Tagged , , | Leave a comment

Enhanced Medical Home for High-Risk Children Dramatically Reduces Hospital Costs, Illnesses

High-risk children suffering from chronic diseases who received comprehensive care at a special clinic at The University of Texas Health Science Center at Houston (UTHealth) experienced dramatic reductions in both serious illnesses and hospital costs, according to a study recently … finish reading Enhanced Medical Home for High-Risk Children Dramatically Reduces Hospital Costs, Illnesses

Posted in Avoidable Hospitalization, Case Managers, Disease Management, Emergency Room, Healthcare Costs, Hospital Readmissions, Improving Patient Care, Intensive Care Unit, Medicaid, Medical Home, Patient Satisfaction, Patient-Centered Medical Home, Primary Care | Tagged , , , , , , , | Leave a comment

Embedding a Case Manager? Consider Workflow Changes, Training Needs

Continually monitoring skills and training needs and evaluating the workflow changes — operational, technological and cultural — inherent in an embedded environment are two important, ongoing challenges when working with embedded case managers, says Annette Watson, RN-BC, CCM, MBA, senior … finish reading Embedding a Case Manager? Consider Workflow Changes, Training Needs

Posted in affordable care act, Avoidable Hospitalization, Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, Embedded Case Manager, Uncategorized | Tagged , , , | Leave a comment

CMS Releases Final Medicare Payment Rules for Value-Based Modifier, Chronic Care Management

CMS has released final rules outlining how Medicare will pay major healthcare providers and suppliers in 2015, including the Value-based Payment Modifier (VBM), which adjusts traditional Medicare payments to physicians and other eligible professionals based on the quality and cost … finish reading CMS Releases Final Medicare Payment Rules for Value-Based Modifier, Chronic Care Management

Posted in Accountable Care Organizations, affordable care act, Alternative Healthcare Coverage, Avoidable Hospitalization, Bundled Payments, Care Coordination, Case Managers, Disease Management, Healthcare Costs, Healthcare Reform, Physician Alignment | Tagged , , , , | Leave a comment

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

Posted in Avoidable Hospitalization, Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, Embedded Case Manager | Tagged , , , | Leave a comment