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Using a multifaceted approach that includes telephone communication, ongoing education, and case management services, CIGNA Health Care is providing a disease management program for Medicare beneficiaries in Georgia with complex diabetes and congestive heart failure.
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The University of Washington School of Public Health and Community Medicine in Seattle, has received a two-year, $656,000 grant from The Robert Wood Johnson Foundation to evaluate the impact of Group Health Cooperatives recent innovations to improve access and quality of care for its members.
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A new, innovative medical management program by Blue Cross and Blue Shield of Illinois helps members take charge of their own health by providing interactive tools and information about health conditions, including opportunities to e-mail a nurse care advisor, personal trainer, registered dietitian, or health coach and get an answer back within one business day.
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Predictive modeling is an invaluable tool in early identification of people who can benefit from case management, but using the score alone doesnt go far enough, says Kay Sherwin, RN, CCM, director of client services for Integrated Healthcare Information Services (IHCIS), a Waltham, MA-based predictive modeling and information solutions firm.
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A perception gap often exists today between what health care providers say, prescribe, and advise, and what patients actually understand and carry out in their self-care. Many factors can influence this gap, including a lack of language comprehension. Yet, even when a patient is well educated, highly conversant, and appears to understand what the health care provider is saying, a perception gap can result.
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A clinical redesign project partnering social work and case management has resulted in a 15% drop in length of stay and a 66% reduction in denials during a period when the average number of cases increased by 24% at Childrens National Medical Center in Washington, DC.
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One of the better known ongoing collaborations in the United States is the Cambridge, MA-based Institute for Healthcare Improvements (IHI) 100,000 Lives Campaign, whose goal is to save 100,000 lives through targeted QI interventions by June 14, 2006.
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Nine years after an automobile accident left her a quadriplegic and seven years after she had a mastectomy following a diagnosis of breast cancer, Janet Brown, RN, BSN, BA, CPHQ, FNAHQ, was surprised to learn that case management services are available through both her independent practice association (IPA) and HMO.
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The devastation and human suffering caused by Hurricane Katrina is mind-boggling. While the television and radio talk shows were filled with people blaming each other for the slow response, home health agencies joined together to address the needs of patients who found themselves away from their homes, unable to reach their own health care providers, and in some cases, separated from their families.
