Case Management Advisor – July 1, 2003
July 1, 2003
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Health plan tailors medical management programs to individual organizations
By identifying the most costly conditions for the health plan and for specific employer groups, Regence Blue Cross Blue Shield of Oregon (BCBSO) has been able to tailor its medical management programs to fit individual organizations and bridge the gap between various components such as case management, disease management, and pharmacy management. -
Comprehensive program bridges gap between CM, DM
Often in health plans, disease management is in one silo, case management is in another, pharmacy management is in another, and they may not interrelate. -
DM program targets low back pain
Low back pain is the second most frequent reason for physician visits, the fifth most frequent reason for hospitalization, and the third most frequent reason for surgical procedures. -
Plan identifies, plugs gaps in DM programs
At Oxford Health Plans based in Trumbull, CT, 3% of its members account for half of the plans medical costs. -
Incentives help sicker patients get the kind of care they need
When Trumbull, CT-based Oxford Health Plans set out to improve care for its sickest members with diabetes and congestive heart failure, it collaborated with primary care physicians and specialists to come up with a plan of care. -
Gaps in accountability impede DM success
Identifying the gaps in care and accountability and closing those gaps is the key to a successful disease management program, says Alan Muney, MD, MHA, executive vice president and chief medical officer for Oxford Health Plans in Trumbull, CT. -
Concentrate on those who will benefit the most
By concentrating its disease management efforts on members who are likely to benefit most, an Indianapolis-based HMO hopes to keep its members healthier and reduce costs to employer groups at the same time. -
Guest Column: Correcting medical errors: How far do you go?
The occurrence of medical errors made by health care providers against patients has been at the forefront of the media in recent years. -
Reports From the Field: New BP guidelines establish diagnosis of pre-hypertension
New clinical practice guidelines for the prevention, detection, and treatment of high blood pressure have been released by the National Heart, Lung, and Blood Institute (NHLBI) in Bethesda, MD. -
Reports From the Field: New AHRQ tool checks patient safety performance
The Agency for Healthcare Research and Quality (AHRQ) has developed a new web-based tool that can help hospitals enhance their patient safety performance by quickly detecting potential medical errors in patients who have undergone medical or surgical care. -
Reports From the Field: IOM seeks improved training to improve quality of care
Changes are needed in the education of physicians, nurses, and other health professionals to improve patient safety and quality of care, according to a new report by the Institute of Medicine (IOM) in Washington, DC. -
Reports From the Field: JCAHO revises scoring for one of its patient safety goals
The Joint Commission on Accreditation of Healthcare Organizations has changed how it scores organizations on its National Patient Safety Goal to eliminate wrong-site, wrong-patient, wrong-procedure surgery.