Case Management Advisor – August 1, 2013
August 1, 2013
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Coordinate care for physical, mental health issues
Researchers and healthcare organizations alike recognize the connection between physical conditions and behavioral health conditions and are working to coordinate care between the providers.Many people with chronic diseases also suffer from depression and other behavioral health issues.People with mental health problems die earlier than the general population because they smoke, are overweight, and have chronic illnesses. Behavioral and physical healthcare providers often operate in silos and lack coordination, which can result in a negative impact on individuals. -
Mental health care gets employees back to work
A study by Aetna shows that employees with a behavioral health condition return to work sooner if their claims are managed by a behavioral health clinician. Employees with a primary or secondary diagnosis of a behavioral health issue are referred to the disability behavioral health unit. The disability behavioral health clinicians identify all the physicians treating the employee and contact each of them, becoming their partner in coordinating care and getting the employee back to work. When employees with a behavioral health issue are seeing only a primary care physician, the disability behavioral health clinicians encourage them to refer patients for specialty behavioral health treatment. -
Readmissions reduced with psychiatric care
Optums Field Care Advocacy program that provides services for people at risk for rehospitalization for a behavioral health condition helps decrease readmissions and extend the time that patients are able to live in the community. Field Care Advocates, who are licensed behavioral health clinicians, work with patients in person and over the phone, help them follow their treatment plan and access needed services, and coordinate care with their providers. They typically work with the patient and providers for 90 days. People with complex needs who have problems following their treatment plan are paired with peer specialists who act as health coaches and work with them for about six months. -
Program joins physical, behavioral healthcare
By coordinating care between behavioral health and medical health providers, Connected Care, part of UPMC Insurance Division, has reduced hospital admissions and emergency department visits for members of UPMC for You, a Medicaid managed care plan as well as Community Care Behavioral Health which manages services for recipients of Pennsylvanias medical assistance program. Case managers at both organizations share a database that shows physical health and mental health interventions for patients in the program. When patients receive services from a mental health or physical health provider or are hospitalized, the care managers make sure all of the patients providers are aware of what has happened. A multidisciplinary team from both organizations develops a plan of care for individuals and assigns a lead case manager who coordinates care with the patients providers. -
Team reduces ED wait times, improves safety
The fast pace of a busy ED can make it difficult to focus in on processes that could be improved, but leadership and commitment can move the needle in the right direction as long as emergency personnel understand why change is important. That, at least, is what Erin Muck, RN, the ED manager and trauma coordinator at Avera Marshall Regional Medical Center, a 25-bed hospital in Marshall, MN, has discovered. The ED treats about 7,200 patients annually, and 100 patients per month are admitted to the hospital from the ED -
What makes for good care coordination?
Ask a doctor if she thinks her hospital does a good job at care coordination or an administrator or board member and shed probably say yes. She might admit to room for improvement, but in all likelihood, she would think she and her peers do a good job taking care of patients in and out of the acute care setting. But the reality is different, says quality guru and Harvard professor Lucian Leape, MD, chairman of an eponymous institute at the National Patient Safety Foundation. -
System said to reduce falls, transfers in elderly
A fall reduction system that encourages caregivers to respond early to warning signs has been proven to significantly reduce falls, according to the manufacturer.