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Project Dulce, a diabetes care management program housed at Whittier Institute for Diabetes in La Jolla, CA, has successfully addressed not only the difficult challenge of helping patients manage their diabetes, but also another issue of growing concern to quality managers: improving outcomes among minority populations.
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Billing data, supply costs, staff costs, and patient satisfaction are top issues for all outpatient surgery managers, but benchmark studies that address these areas don't always focus on similar procedures so that comparisons can be made easily.
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Health services is the largest private industry sector in the United States, but being trained in health and safety did not prevent that group from being the most-injured group of workers in 2002 more health care workers were hurt on the job that year than construction workers and miners combined.
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When a team of physicians, nurse practitioners, case managers, and social workers provided care for at-risk members of Priority Health health plan in their homes, emergency department visits and inpatient admissions for patients in the program dropped by 47%.
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A multidisciplinary team at CareSource, a Dayton, OH-based health plan, coordinates care for at-risk pregnant women and follows them for a year, or longer, after the birth.
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Margaret Leonard, who recently was presented the Lifetime Achievement Award by the Case Management Society of America, points out that the Affordable Care Act and other legislation all include the concept of care coordination.
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Case managers are beginning to get the recognition they deserve and National Case Management Week Oct. 12-18 is the time to celebrate all the contributions that case managers bring to the healthcare arena.
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Like many hospitals around the country, Mercy San Juan Medical Center in Carmichael, CA, has seen a steady increase in patients presenting to the ED with mental health problems. Officials attribute the problem to dwindling resources for mental health care and, in particular, the closing of an inpatient psychiatric unit in the region in 2009. Many of the patients who previously would have been stabilized in the inpatient unit are now showing up in the ED.
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Care navigators meet with EmblemHealth members at primary care practices and coordinate all their non-clinical needs.
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