By creating a series of tools and other resources, Premera Blue Cross has been able to increase the efficiency of its case management department and earn coveted accreditation from Washington, DC-based URAC. The case management program at the Mountlake Terrace, WA, health plan is one of only two in the state of Washington to achieve URAC accreditation. The health plan covers members in Washington and Alaska.
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If youre looking for opportunities to enhance your case management career, consider becoming a case management expert witness. As case management comes under closer scrutiny in the legal system, there are more opportunities for case managers to be called on to speak on standards of practice, ethics, and other issues.
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It sounds exciting to be an expert witness until you take the stand in court and the attorney for the other side questions your credibility, B.K. Kizziar asserts. Thats why she advises case managers who are interested in becoming expert witnesses to learn how the legal system works and be prepared for what they may encounter in a case.
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Drawing on its 30 years of experience in employee assistance programs, CIGNA Behavioral Health has begun a new Student Assistance Program to help students adjust to life on a college campus and cope with common behavioral health concerns such as stress, depression, suicide, and alcohol and substance abuse.
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In an effort to ensure that chronically ill members get the most effective and efficient health care services, BlueCross BlueShield of Tennessee has developed a pilot project to pay physicians for e-mail consultations, telephone calls, and group visits with members with diabetes, hypertension, or congestive heart failure.
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Adults with lower than average reading skills are less likely than other Americans to get potentially life-saving screening tests, be vaccinated for flu and pneumonia, and take their children for well-child physician visits, according to a report by the federal Agency for Healthcare Research and Quality (AHRQ).
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Documentation is a valuable communication tool throughout the case management process, providing an accurate record of the assessment, care plan, and execution of treatment and services. Through systematic collection of information about the service experience, the end results of care can be evaluated.
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