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In a ground-breaking analysis, the Institute of Medicine has calculated what the United States loses each year due to poorer health and early deaths among the 41 million uninsured people in the United States.
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State purchasers, policy-makers, plan executives, and consumers should not dismiss public sector managed care or assume it has arrived at the end of its cycle. Thats the conclusion of a working paper published by the Lawrenceville, NJ-based Center for Health Care Strategies on what lies ahead for Medicaid behavioral managed care.
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While states budget problems are limiting interest in attracting new people to the Medicaid program, that situation will surely change at some point, and then states will be looking for ways to reach out to those eligible for Medicare. A study by Mathematica Policy Research senior health researcher Suzanne Felt-Lisk says one model that states can use to improve outreach to Medicare beneficiaries is the SCHIP program and its intense focus on enrolling all who are eligible for it.
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Accelerating health care spending. A steep and lengthy drop in revenues. These twin evils are at the heart of the states ongoing fiscal crisis, says the National Governors Association.
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The goal of an initiative to support new training, technical assistance, and grant-making for up to six states interested in developing quality-focused pharmacy management strategies, which will start this fall, is to find feasible solutions that improve quality, reduce costs, and are amendable to all stakeholders.
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A by-product of efforts to increase patient empowerment and involvement in their own care is the use of quality-of-life assessments in evaluations of state Medicaid programs.
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To alleviate the problem of social admissions from the emergency department, Northeast Medical Center in Concord, NC, established an ED case management staff and made arrangement with local assisted living facilities to admit patients directly from the ED.
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Before Thomas Hospital in Fairhope, AL, redesigned its case management program, nurses from two separate departments social services and utilization review performed case management-type functions. In 2002, the hospital hired a division director to redesign its case management program and oversee the social work, discharge planning, and utilization review functions.
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The Joint Commission on Accreditation of Healthcare Organizations has slashed the number of standards in the 2004 hospital accreditation program from 508 to 225 as part of the agencys Shared Visions, New Pathways initiative.
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Its one thing to keep everything moving swiftly throughout the ambulatory surgery process, but dont let the quick pace affect the completeness or accuracy of your documentation.
