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A program that targets women at risk for premature deliveries for case management has paid off for ConnectiCare, a regional HMO based in Farmington, CT.
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Two programs at Passport Health Plan help pregnant Medicaid recipients overcome the obstacles to a healthy pregnancy and follow preterm infants through the neonatal intensive care unit and back home.
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A 2003 Center for Medicare & Medicaid Services (CMS) regulation that interpreted EMTALA not to apply to inpatients does not have the "force and effect of law," according to a recent decision by a U.S. District Court in Puerto Rico.
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Patients with heart failure may be among the most challenging for case managers who are coordinating their care. Patients with heart failure must take multiple medications, eat a low-salt diet to keep their condition under control, and monitor their condition constantly.
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By locating a social worker in hospital emergency departments to help members overcome barriers to primary care, Horizon NJ Health was able to decrease ED visits by 45% among members who had a face-to-face conversation with the social worker.
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A new web site, www.CalHospitalCompare.org, enables Californians to compare the performance of more than 200 hospitals statewide on a variety of quality measures from maternity services to cardiac treatment.
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When members of Blue Cross Blue Shield of Florida are seriously ill, injured, facing surgery, or need help negotiating the health care system, their care is managed by a care coordinator located in their region.
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Patients with life-limiting conditions who received patient-centered management had dramatically reduced utilization and cost of care compared to patients with similar conditions who received regular case management, a study by Blue Shield of California has concluded.
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Discharge planners/case managers may encounter physicians who insist upon making referrals to specific post-acute providers. These physicians may serve as medical directors or provide consulting services to the providers to whom they insist upon making referrals. Are these types of arrangements appropriate?
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When The Joint Commission released information on how to narrow the communication gap between patients and health care practitioners to improve patient safety, some people in the field of patient education said, "It's about time."
