Hospital Case Management – February 1, 2024

Care Management Aided by Solutions to Social Determinants of Health Needs

When a healthcare system asked clinical staff in all settings to screen patients for social determinants of health, patients’ personal struggles became apparent. The next step was more of a challenge — developing solutions.

‘Payvider’ Model Is a New Trend for Care Coordination and Addressing Social Needs

Case management and care coordination often are seen as ways to improve patient care outcomes, reduce readmissions, and make hospital-to-community care more efficient. However, resources remain limited in care coordination efforts because of the payment disincentive. A solution that is gaining steam is the “payvider” model.

More Efficient Social Care Programs Could Improve Screening and Tailor Solutions

Researchers are finding that Accountable Health Communities need greater flexibility in activities geared toward improving patients’ health-related social risks. The Centers for Medicare & Medicaid Services adopted quality metrics for health systems, requiring them to screen for health-related social risks. The authors of a new study found that the model does not allow for the flexibility needed to ensure hospitals sustain the adoption of AHC activities.

Novel Method Proposed to Optimize Care Coordination

Healthcare organizations need new methods to improve care coordination and patient-centered care. A co-author of a recent study proposes a method to determine whether a patient needs primary care or specialty care, naming the categories as “lifer” and “destination.”

Social Needs Data Are Useful, but Consistent Collection Needed

Case managers and researchers need data that can be used to improve care coordination and prevent hospitalizations and ED visits. But the challenge is deciding which patient data are useful and which are not.

Preventive Care During an Emergency Requires Effective Care Coordination

The COVID-19 pandemic disrupted standard health system practices in a way that allowed healthcare researchers and professionals to learn how to improve their preparedness for emergencies and disasters. Case management leaders and others in health systems need to think about their workflow and how it was disrupted during the early months of the pandemic, as well as later in the crisis.

Navigating Elder Care and Long-Term Care

Elder care in the United States is increasingly a “major source of moral distress in the hospital case management and social work world,” according to Lisa Bednarz, LCSW, CMAC, ACM-SW, ASW-G, regional director of case management for Robert Wood Johnson Barnabas Health.

Working with Private Care Management Professionals to Help Aging Patients

While inflation continues to be a part of the economic landscape of 2024, aging healthcare consumers and their families are considering their options for managing care. With that, private care management, paid for by the consumer, is becoming more popular. These private care management professionals work with clients and their families to design a care plan to carry them through the various stages of aging.