Hospital Case Management – January 1, 2014
January 1, 2014
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If the face is familiar, the patient may be overusing healthcare
Every hospital has patients it sees over and over, often for preventable conditions or problems that could be treated in a lower level of care. According to the Agency for Healthcare Research and Quality, the top 1% of healthcare users account for 21.4% of healthcare expenditures. In this issue of Hospital Case Management, we'll show you what case managers are doing to help patients avoid unnecessary hospital visits and to seek treatment in an appropriate level of care. You'll learn how one hospital's "red carpet treatment" has cut hospital visits among super utilizers, how embedded case managers target high utilizers, and how dealing with social issues helps keep patients out of the hospital. We'll describe a community approach to mental health transitions and a program to help emergency department patients navigate the health system. -
Super-utilizers get Red Carpet treatment
MetroHealth Medical Center in Cleveland has partnered with two health plans to provide intensive care coordination for high-cost patients with multiple medical problems and, often, behavioral health issues. -
CMs coordinate care for frequent utilizers
At the University of Michigan Health System, complex case managers coordinate inpatient and outpatient treatment and psychosocial services for patients who frequently visit the emergency department or are hospitalized. -
Community collaborates on services for mentally ill
Faced with the closing of the state psychiatric hospital in their community, hospitals, law enforcement, mental health providers, and community agencies in Raleigh, NC, began collaborating on improving care and transitions for the mentally ill. -
Case managers coordinate discharge
At Duke Raleigh Hospital, case managers in the emergency department lead interdisciplinary behavioral health rounds each day on all patients with psychiatric signs and symptoms. -
ED navigators help patients find a PCP
Carondelet Health Network in Tucson, AZ, places community health outreach workers in the emergency department to help patients who use the ED for non-emergent conditions find a primary care provider. -
Embedded CMs work with high-risk patients
Care managers embedded in primary care clinics work with patients with high-risk diagnoses and multiple visits to the emergency department or hospital.