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Suppose you're a hospital case manager under pressure to move patients to another level of care and free up beds for patients boarding in the emergency department. What do you do if you think a patient really needs to stay in acute care?
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An innovative care coordination pilot project jointly developed by AmeriHealth Mercy Family of Companies' Keystone Mercy Health Plan based in Philadelphia, PA, and providers affiliated with the Mercy Health System, also based in Philadelphia, PA, resulted in decreased costs, reduced hospital admissions, and a decrease in inpatient days for members in the health plan's Medicaid managed care plan.
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AmeriHealth Mercy's care coordinator, Lynne Major MSW, CCM, touches base with every member who comes into the physician office where she works, encourages them to call her if they have questions and spending extra time with those who have complex needs.
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The Department of Health and Human Services'(HHS) recently published proposed rule (42 CFR 425) for Accountable Care Organizations (ACOs) could result in some positive changes for the health care industry, but there are a few problems that should be corrected, an expert says.
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Proposed rules for the creation of Accountable Care Organizations (ACOs) will require participating organizations to provide primary care to 5,000 or more patients and to meet 65 quality standards.
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Hospitals are working more proactively in forging relationships with the next-level-of-care providers, the experts say.
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When you're troubled by an ethical dilemma, don't go it alone. Reach out to your peers and your professional organizations for help, the experts say.
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What content should go on electronic readers, such as iPads and Nooks, purchased for use in community health libraries and facility-based resource centers?
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Paid caregivers make it possible for seniors to remain living in their homes.
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"This was a new patient who had a severe hand injury and was seeing a microsurgeon for an evaluation.
