Posts Tagged ‘patient-centered approach’

11 Innovations in Healthcare Case Management

July 23rd, 2012 by Jackie Lyons

According to respondents from HIN’s third annual healthcare case management survey, successful case management efforts focus on transition coaching, discharge planning, reward programs and a patient-centered approach to case management.

Despite the challenges of staffing and operating a successful case management company brought on by healthcare reform and the changing industry, respondents contributed innovative interventions that improve health and reduce costs in the populations they serve.

Eleven case management program interventions that proved to be successful are:

1. Working with local community collaboratives for transition coaching. For example, respondents collaborate with a company that performs in-home health assessments on members identified with chronic diseases. The information is sent to them and they use it to direct care for their members.

2. Scheduling home visits by nurse practitioners for selected patients.

3. Redirecting to in-network providers and coordinating services in an efficient manner to prevent delay in discharges.

4. Holding case conference meetings with the treating physicians, case managers, medical directors and other related parties to address issues related to challenging or high-risk patients.

5. Verifying medication and home healthcare strategies to prevent readmission for chronic illness within 24 to 48 hours.

6. Partnering with social workers who will spend time dealing with complex family problems and end-of-life care.

7. Getting high-risk obstetrical clients to assume greater accountability for the outcome of their pregnancies and communicating with providers and educators. Respondents noted a significant decrease in low birth weight infants for RN case-managed programs focused on these objectives.

8. Utilizing diabetes reward programs to keep measures in line.

9. Integrating case management (medical and behavioral health) for a patient-centered approach.

10. Using neutral assessment and family trust to establish realization that case managers can identify affordable and appropriate resources.

11. Attaining the Advanced Achievement in Transplant Management Certification (through Interlink Health Services) so case managers better understand and educate patients about the benefits of using a Transplant Center of Excellence for the best possible clinical and financial outcomes when a transplant is needed. Respondents report successful clinical outcomes and savings range in the 40-50 percent range.