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Since Fallon Community Health Plan in Worcester, MA, began integrating medical case management and mental health case management, members in the health plan's Medicaid HMO with medical issues have experienced fewer inpatient days and emergency department visits and those in behavioral health have less need for unplanned medical care, says Dena Miller, RN, MSN, vice president of clinical innovation and implementation for the health plan.
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To keep a lid on costs, health care policy experts recognize that hospitals need to find more effective ways to manage transitions. The care coordination piece can be particularly problematic in the fast-paced ED setting, and yet it can make a big difference in determining whether a patient receives appropriate follow-up after an acute event and whether he or she is back in the ED within days or weeks with another acute exacerbation of the same issue.
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A collaborative approach in which primary care physicians and nurse case managers work with patients with depression has resulted in a 50% improvement of scores on a depression questionnaire among patients who were part of a pilot project at UC Davis Family Medicine in Sacramento.
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As the National Committee for Quality Assurance hopes that all-cause readmission rate reporting by health plans will assist in creating more consideration of patient care across the continuum, the National Quality Forum (NQF) hopes a new measurement framework for multiple chronic conditions will likewise help improve care in and out of the hospital.
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Recognizing that medical problems and behavioral health issues are often intertwined, payers and providers are coordinating behavioral health and medical health case management.
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In the past, if a member of Capital District Physicians' Health Plan (CDPHP) in Albany, NY, was hospitalized for a suicide attempt and ended up in the intensive care unit, or was hospitalized with a medical problem and diagnosed with a behavioral health issue as well, the medical case manager would give him or her a referral to a toll-free number for an out-of-state vendor that provided behavioral health management for the health plan.
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Some employers are taking advantage of people's tendency to post explicit and sometimes disparaging information about themselves on Facebook and other media by demanding access to those sites before hiring. After incidents in which patient information was posted on Facebook, some healthcare providers might consider monitoring employee sites on an ongoing basis.
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An autopsy determined that Anna Brown's death in a jail cell in September 2012 was caused by blood clots that formed in her legs and migrated to her lungs, according to authorities in St. Louis, MO. Police say Brown went to three hospitals complaining of leg pain in the days leading up to her death, including her visit to St. Mary's Health Center that led to her arrest for trespassing.
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Continuing reports of security breaches resulting in the loss of sensitive patient data show the weaknesses of some healthcare organizations, and some experts say criminals are targeting healthcare for cyber attacks.
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Encryption would sharply reduce the risk of damage from any loss of data, and widespread use could discourage thieves from trying to access healthcare information, says Brad Rostolsky, JD, an associate with the law firm of Reed Smith in Philadelphia who has worked with healthcare providers to ensure data security. Rostolsky acknowledges that encryption can be costly for a large organization.
