Category Archives: Case Managers and the Patient Experience

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

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

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

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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

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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

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 , , , | Leave a comment

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

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

Case Managers Coach Patients on Readmission ‘Red Flags’

Seeing patients within seven days of hospital discharge is key to avoiding “red flags” that can land that patient back in the hospital, says Dr. Randall Krakauer, MD, national Medicare medical director for Aetna. Red flags can range from patients … finish reading Case Managers Coach Patients on Readmission ‘Red Flags’

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8 Percent Fewer ER Visits for Patients Treated in Patient-Centered Medical Home

Patient-centered medical Homes (PCMHs) reduce emergency department visits for the chronically ill by nearly 8 percent, according to a study authored by Independence Blue Cross (Independence) and CTI Clinical Trial and Consulting Services (CTI), and published by Health Services Research. … finish reading 8 Percent Fewer ER Visits for Patients Treated in Patient-Centered Medical Home

Posted in affordable care act, Avoidable Hospitalization, Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, electronic health records (EHRs), Patient-Centered Medical Home | Tagged , , , | Leave a comment

6 Drivers of Successful Dual Eligibles Care Management

Successful care management of dual eligibles, a population that constitutes about 9 million individuals in the United States, presents specific, multiple challenges, explains Timothy C. Schwab, MD, FACP, is chief medical officer of SCAN Health Plan. One key to success … finish reading 6 Drivers of Successful Dual Eligibles Care Management

Posted in Care Coordination, Care Transitions, Case Managers, Case Managers and the Patient Experience, Medication Adherence, Patient Satisfaction | Tagged , , , | Leave a comment