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A system to help identify patients who are at risk for suicide, chemical dependency, or premature treatment termination is a great adjunct to traditional psychiatric care, asserts Daryl E. Quick, PhD. Quicks organization, Western Psychological and Counseling Services, uses the ALERT Predictive Modeling and Outcomes Management System from PacifiCare Behavioral Health.
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When QMed contracts with a health plan to manage its coronary artery disease, heart failure, or diabetes population, the Laurence Harbor, NJ, disease management firm does more than just rely on claims data to come up with a treatment plan for members identified for disease management. The company also sends a team of specialists into individual physician offices to extract data from the patient files of members identified for the program, often coming up with clinical information and medical histories that arent available from the insurance carrier.
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A field-based disease management care program in which nurses meet face to face with members with chronic kidney disease and end-stage renal disease has resulted in dramatic decreases in emergency department (ED) visits and hospital bed days for patients managed by RMS Disease Management Services in Vernon Hills, IL, an affiliate of DaVita Inc.
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When new members enroll in one of Blue Cross and Blue Shield of Oklahomas (BCBSOK) health promotion programs, they receive free equipment to help them monitor their chronic disease.
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Thanks to wireless technology, case managers working in Chicagos poorest neighborhoods no longer have lengthy waits to get referrals to other agencies for their clients.
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An intensive face-to-face care management program for severely ill Medicare patients with advanced congestive heart failure and/or complex diabetes has paid off for XLHealth, a Baltimore-based disease management firm. The company has reduced spending by as much as 26% after 24 months of intervention for private HMO patients and has reduced lower limb amputations by more than 60%.
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It is a well-known fact in the health care community that there are diabetes disparities among ethnic groups. Diabetes is a problem throughout the United States. An estimated 18 million people suffer from the chronic disease, and people of color are more likely to develop Type 2 diabetes.
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For as long as humans have been taking care of other humans who are sick or hurt, the rendering of solace and physical comfort has been the core from which all other types of aid have grown. But a nurse and ethicist in California says that ignoring the value of giving of solace and comfort amounts to turning away from the prime reason for the practice of medicine.
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A Harvard Medical School study has found that current practice management strategies and financial arrangements have a limited impact on the quality of care for patients with diabetes.
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As part of its efforts to promote preventive care and appropriate management of chronic diseases, Blue Cross and Blue Shield of Florida has begun the Recognizing Physician Excellence (RPE) program, which will reward physicians based on several criteria, including patient satisfaction, clinical quality and efficiency, and administrative efficiency.
