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At Integrated Home Care, nurse case managers provide hands-on care as well as handling the traditional case management duties, such as evaluating patients, developing a customized plan of care, coordinating with other members of the health care team, and arranging services such as social work or dietitian services.
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At Humana Inc., specially trained registered nurses called Personal Nurses fill the gap between the companys traditional case management and disease management programs. The nurses, who work from home-based offices, call members identified by a predictive model as likely to need health care interventions in the future, says Trish Whitt, RN, director of clinical product management for the Louisville, KY-based health benefits company.
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Achieving ISO 9001:2000 registration has helped Humana Inc.s Personal Nurse service move quickly to respond to customer feedback and improve services.
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Aetnas award-winning disease management programs focus the companys resources and nursing skills on the patients for whom it can make the biggest difference.
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When a person acquires a disability and can no longer perform the required tasks of his or her job, vocational rehabilitation is needed to help the individual return to work in another capacity. To facilitate this process, an analysis of transferable skills should be conducted up front.
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As part of its mission to provide peace of mind to members, Premera Blue Cross has developed an innovative case management program to help members with breast and lung cancer understand their disease and make informed choices about their treatment options.
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When Ira Mandel, MD, MPH, was a physician in private practice, he found that group visits were an effective way to cover disease-management issues with his patients with diabetes. As executive medical director for Health Integrated, a Tampa, FL-based provider of care management services, he adapted the group visit concept for telephone-based case managers.
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Salaries for case management are increasing, but the vast majority of case managers are working far more than the traditional 40-hour week, according to the results of the 2004 Case Management Advisor Salary Survey.
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Midcycle self-assessments, tracer methodology, and less emphasis on examination of policy books are signs that the new survey process implemented by the Joint Commission on the Accreditation of Healthcare Organizations is truly different from the survey process of the past.
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A customer service associate for a large company, whose days at work are spent taking customer calls at her desk, injures her back and is determined by her companys physician to be disabled. Six weeks later, she still has some back pain, so her physician does not clear her to return to work; however, she goes on vacation with her family, plays tennis, and swims.
