Case Management Advisor – April 1, 2012
April 1, 2012
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Case managers protected from liability by documenting
As they go about their day-to-day activities, case managers should take steps to protect themselves from possible legal action if the patients whose care they manage experience an adverse outcome. -
Home-based program offers care for complex patients
When Cigna HealthCare of Arizona Medicare Advantage members are homebound, have complex care management issues, or are at risk for readmission to the hospital, the home-based care team from Cigna Medical Group, located in Phoenix, visits the patients in their homes, assesses their needs, and arranges for the services they need to stay healthy and safe in the home environment. -
Health plan reduces high-risk conditions
A proactive approach to engage at-risk members before they have an adverse medical event is paying off for CareFirst BlueCross and Blue Shield, a Baltimore-based health plan. -
Tool that assesses home care has a flaw?
The assessment tool used by federal government programs to measure whether a community health center is functioning as a "medical home" was developed by the nonprofit National Committee for Quality Assurance (NCQA). -
Problem of substance use and rehospitalizations
Researchers have found that patients who are diagnosed with a substance use disorder are about twice as likely to be readmitted to the hospital as patients without this diagnosis. These findings suggest that hospitals could intervene with substance use screening and programs designed to reduce subsequent hospital utilization.1 -
Avoid denials — Get it right from start
When an interdisciplinary team including patient access, insurance verification, and radiology personnel was formed to reduce claims denials, "realizing where denials are coming from was definitely our first step," reports Brian A. Todd, CHAM, manager of patient access staff development and training at Lourdes Health System in Camden, NJ. -
Quality ED requires hospital efforts
A study published in The Journal of the American Medical Association (JAMA) found that there is no significant difference between safety-net and non-safety-net hospitals when it comes to the length of stay for emergency patients. -
Weight training improves Parkinson's
New research suggests weight training for two years significantly improves the motor symptoms of Parkinson's disease compared to other forms of exercise such as stretching and balance exercises. -
Medical debt keeps rising
Hard hit by one of the worst recessions in nearly a century, hundreds of thousands of Californians lost insurance coverage across the state as employers shed jobs and the health plans that came with those jobs, according to a report from the University of California, Los Angeles (UCLA) Center for Health Policy Research.