Case Management Advisor 2002-12-01

Enhance job security by proving your worth to your organization

In these days of increasing health care costs and decreasing resources, its essential that case managers get more savvy about documenting and putting a dollar value to what theyve accomplished if theyre going to survive the inevitable budget cuts.

Document the savings of your interventions

When Peter Moran, RN, CM, BSN, MS, CCM, was a case manager for a payer organization that was considering cutting personnel, he was able to document that case management interventions netted his organization $190,000 in hard cash savings over the course of three quarters.

Productivity tracking can show how hard you work

By tracking the productivity in her department, Joann C. Milne, RN, BSN, CRRN, PHN, was able to show that she and her case managers were working at 160% productivity.

How to calculate how long it takes to do your job

Team approach helps high-utilization patients

A team approach to managing patients who are likely to be high utilizers of health care resources has paid off at HealthCare Partners, a large multispecialty medical group in Los Angeles County serving more than 450,000 patients.

Involve primary care docs in your CM efforts

Managing the care of patients should be a partnership between the case manager and the primary care physician, Ellen Aliberti, BSN, PHN, MS, CCM, says.

Education is first step in end-of-life initiative

Educating the internal staff was the first step in Highmark Blue Cross Blue Shields Advance Care Planning/End-of-Life Care program.

CM guide members on end-of-life decisions

When case managers at Highmark Blue Cross and Blue Shield talk to their members, they take steps to ensure that the members have advanced care-planning documents in place.

Revised CMSA standards reflect new CM issues

The 2002 version of the Case Management Society of Americas (CMSA) Standards of Practice are designed to reflect the role of the case manager in the changing health care system.

RM principles can protect you from liability

Detailed documentation can help case managers minimize their risk if a patient or family member sues the organization for which they work, says Susan Gilpin, JD.

Don’t get caught in the ‘us-vs.-them’ scenario

There is an us-vs.-them scenario that occurs in health care, and the case manager sometimes is caught in between, trying to make sure the patient gets appropriate care, says Susan Gilpin, JD, chief executive officer of the Commission for Case Management Certification in Rolling Meadows, IL.

Six ways to minimize your risk in lawsuits

Reports From the Field: CM intervention help cardiac patients control cholesterol

Patients who get follow-up care from a nurse after heart bypass surgery are more likely to control cholesterol and reduce the risk of further disease, according to a study from the Johns Hopkins University School of Nursing in Baltimore.

Reports From the Field: Quality ratings have no effect on consumer choices

Quality ratings for hospitals, health plans, and physicians have almost no impact on the choices consumers make, a new study by Harris Interactive has concluded.

Reports From the Field: Limiting allergy, asthma drugs may adversely affect patients

The move to limit the use of allergy and asthma drugs by increasing copayments, restricting access to newer drugs, and requiring preauthorization for their use may have had an adverse impact on allergy and asthma patients, according to the American College of Allergy, Asthma, and Immunology (ACAAI).

Reports From the Field: Brachytherapy is effective treatment for breast cancer

Brachytherapy is an effective modality for treatment of breast cancer, according to a study presented at the fall meeting of the American Society for Therapeutic Radiology and Oncology.

Reports From the Field: Hospital charges rise, LOS drops

The average hospital charge for treating a patient admitted for a heart attack increased by about one-third between 1993 and 2000, according to data from the Agency for Health-care Research and Quality (AHRQ).

Case Management Advisor – December 1, 2002

December 1, 2002