Case Management Advisor – September 1, 2012
September 1, 2012
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Health plans focus on inappropriate emergency department use
Faced with an increase in patients who seek care in the emergency departments for non-urgent conditions, health plans are looking for ways to reduce unnecessary visits to the emergency department and steer patients to more appropriate levels of care. -
Multi-pronged approach targets ED use
UPMC Health Plan in Pittsburgh, PA, takes a three-pronged approach to reducing unnecessary emergency department visits that includes outreach calls from care managers, stationing a patient navigator in an emergency department that serves a large UPMC population, and home visits by a nurse/social worker team for patients who need extra help in managing their healthcare. -
Home visits give support for at-risk members
When members in UPMC Health Plan's Special Needs Plan are experiencing excessive hospital admissions and/or emergency department visits, the health plan sends a team of social workers and nurses to their homes to assess the members' healthcare and psychosocial needs and get them the resources they need to stabilize their conditions. -
Program targets ED use for non-urgent conditions
When members of Passport Health Plan use the emergency department for non-urgent conditions, the health plan calls them to find out why they chose that level of care. -
CMs meet mental health clients face to face
By meeting their clients face-to-face and building relationships, case managers at the Mental Health Association of Westchester County, NY, are able to help adults and children working through mental illness or emotional distress access the kind of help they need to stabilize their conditions, says Amy Kohn, PhD, chief executive officer of the private not-for-profit mental health multi-service organization in Tarrytown, NY. -
First-episode schizophrenia patients need care quickly
Mental health experts believe that as with many acute medical conditions such as stroke and heart attack, early diagnosis and treatment can make a critical difference for patients with schizophrenia, potentially limiting the severity and progression of the disease. -
LEP patients best served with interpreter in ED
Hospitals that receive federal funds are required by law to offer language assistance to patients with limited English proficiency (LEP).