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When Blue Cross Blue Shield of Michigan created its proactive case management and disease management program, the Detroit-based insurer looked for every opportunity to interact with members, in addition to maximizing the traditional disease management and case management strategies.
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Before Blue Cross Blue Shield of Michigan launched its BlueHealthConnection program, disease management nurses and case management nurses were in separate departments and never talked.
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When Blue Cross Blue Shield of Michigan decided to create a proactive case management and disease management program, the Detroit-based insurer turned to predictive modeling to identify which of its members were eligible for the BlueHealthConnection program.
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Its not unusual for members covered by Blue Cross Blue Shield of Arkansas to drop by the office and visit their case manager in person.
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Medicaid recipients with chronic diseases are a difficult population to reach. Often, they're transient and face economic, linguistic, and cultural barriers to health care. Thats why McKesson Corp., based in San Francisco, came up with a series of outside-the-box initiatives in its disease management programs for Medicaid patients whose care is not covered by a managed care contract.
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Some people who are considering bariatric surgery as a weight-loss option may think they can have a minor operation and start losing weight automatically without having to think of dieting again. Thats where Michelle Coffman, RN, and Sue Lassetter, MA, come in.
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Increasing numbers of elderly Americans spend their last days in nursing homes, and very few benefit from hospice services, experts say. Researchers and national health care experts predict that the number of people who die in nursing homes or other long-term care facilities will continue to rise in coming decades as the baby boomers age.
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Whether to meet continuing education requirements, get a better job, or to satisfy a personal desire to improve in the profession, occupational health nurses always are looking for opportunities for professional development.
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The Case Management Society of America (CMSA), based in Little Rock, AR, is changing all that with the development of Case Management Adherence Guidelines (CMAG-1) designed to guide case managers in helping their clients stick to their prescribed medication regimen.
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A home monitoring program for patients with complex chronic conditions has reduced hospitalizations by as much as 50% to 80%, according to Charles Hart, vice president of Cardiocom, a Minneapolis-based company that works with managed care companies, hospitals, and medical groups at risk for cost of care to manage complex patients.
