Healthcare Case Management Certification Article on Value Based Care

Fee for service models are becoming less and less and value based care is taking over healthcare.  Providers need to supply better care and quality to patients.  They need to limit un-needed procedures and tests and instead focus on better care to reduce readmissions, decrease cost and improve patient health.  Payers are rewarding providers who supply better quality based care.

Value based care is important for not only the patient but also providers and payers. Please also review AIHCP’s Healthcare Case Management Program

 

The article, “Value-Based Care Assessment: The First Step to Value-Based Care” by Emily Sokel looks closer at how to start implementation of such plans and models.  She states,

“Starting the transition from fee-for-service to value-based care is a challenge. Many provider organizations are simultaneously juggling new reimbursement models with old ones and breaking institutional memory to meaningfully move toward changes.  One hospital began its journey to value-based care with an organizational assessment. The value-based care assessment helps the hospital understand which value-based care contracts it is most prepared for and how to balance this transition with existing fee-for-service reimbursement, the director of case management told Insights during a recent anonymous discussion about the division’s latest findings.”

To read the entire article, please click here

Switching to a value based care model is important for providers as government payers and private payers demand more accountability for patient health and cost.  It is essential to increase the quality of care for all parties involved.

Please also review AIHCP’s Healthcare Case Management Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified healthcare professionals seeking a four year certification in Case Management

Case Management Program Article on Prolonged Stays in Hospital

One of the biggest problems in care is cost.  Long visits and efficient care increase any cost.  Sometimes hospital visits can become so long that cost is driven up immensely.  This may be sometimes necessary but in other cases, better coordination can prevent unneeded lengthy stays that increase cost and insurance issues.

Prolonged stays at hospitals albeit necessary can sometimes become issues cost wise. Please also review AIHCP’s Healthcare Case Management Program

 

The article, “How a hospital becomes a costly hotel for patients who can’t leave” from UCDavis Health looks at patients caught in limbo of the healthcare system.  The article states,

“Extreme length of hospital stay – defined as 100 days or more – is not unusual at an academic medical center like UC Davis. A premature infant who requires intensive neonatal care to survive and thrive needs a lot of time in the hospital. The burn patient who needs specialized treatments, physical therapy and skin grafts often requires months of care, too. UC Davis Health has unique expertise for these types of lengthy, acute-care cases.”

To read the entire article, please click here

Please also review AIHCP’s Healthcare Case Management Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Case Management.

 

Case Management Program Article on Disparities in Cancer Care

Case Managers can play a key role in helping cancer patients with a variety of different issues discover proper routes in care and recovery.  Case Management is essential to collection of information and properly using that information for the overall benefit and health of the patient.  It is extremely important in the case of cancer cases.

Case Managers can play a key role in cancer recover. Please also review AIHCP’s Case Management Program

 

The article, “Health Disparities in Cancer Care” by Marissa Fors from Oncology Nursing News looks closer at issues that vary in quality of cancer care from one person to another.  The article states,

“Cancer patients face many obstacles to care, including financial, psychosocial, and practical barriers. Health disparities also prevent patients from receiving optimal treatment. In order to be an effective case manager, health care professionals must have a clear understanding of the definition of this role, the overall benefits of case management, and how to assess patients’ needs. The priority must be to put the patient first in order to improve outcomes. Addressing inequities in access to care is essential to adequately enhance a patient’s wellbeing.”

To read the entire article, please click

Please also review AIHCP’s Case Management Training Program and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Case Management

Case Management Certification Article on Outcome Improvement and Revenue Recovery

Contact with patients is key to good case management.  Communication, updates and ensuring patients meet recovery requirements, as well as future preventative measures.  These things improve patient outcomes but also increases revenue for the facility.

Better patient outcomes is best for the patient but also the financial security of hospitals. Communication is key in ensuring better outcomes and regular recovery as well as preventative visits. Please also review AIHCP’s Case Management Certification

 

The article, “Closing Gaps in Care: Improving Patient Outcomes and Revenue Recovery” by Jaci Haack looks at three ways hospitals and other healthcare facilities can better engage patients and also increase revenue in the process.  She states,

“Encouraging patients to return to care sooner will not only ensure better outcomes but also ease the healthcare system back to normal. Given the magnitude of postponed care, this will hopefully quell a sudden wave of hospitalizations for newly diagnosed conditions that could overwhelm hospitals that may be facing another COVID-19 surge.”

To read the entire article, please click here

As society attempts to recover from the virus, it is important to engage patients to ensure quality care and prevention.  It is also important for healthcare to continue to grow financially so it can continue to offer services to patients.  Better Outcome Patient Management is key to this and communication is pivotal

Please also review AIHCP’s Case Management Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification as a Healthcare Case Manager.

Case Management Certification Article on Quality Care in Health

Quality improvement in any industry is important and healthcare is no exception.  If so, healthcare even carries a higher call for quality since it deals with human lives.  Case Managers can play a pivotal role in ensuring quality care at every phase of admission to follow up care.  Without good quality measures, outcomes would drop and most importantly quality of human life or even death can result.

 

Quality improvement in healthcare starts with admission and ends with follow up care to ensure the best outcomes. Please also review AIHCP’s Case Management Certification Program and see if it meets your needs.

 

The article, “What is Quality Improvement in Healthcare?” by Danielle Gagnon looks closer at quality care in healthcare and how to maintain and improve it.  He states,

“When healthcare leaders set goals for their organizations, such as preventing patient falls, or a medical system aims to lower opioid use after surgery, they use a process called quality improvement. But what is quality improvement in healthcare really about?”

To read the entire article, please click here

Please also review AIHCP’s Case Management Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Case Management.

Case Management Considerations: When Should You Consider Hospice Care?

Terminally ill fatherBy: Dominick L. Flarey, Ph.D, RN-BC, MBA, ANP-BC, FACHE

Executive Director
The American Academy of Case Management

 

Case Managers today are on the front lines of palliative care and hospice care. Such models of care are complex and require the management of patients with very holistic health care needs including physical, emotional and spiritual. Patients and families often find that making choices about entering a hospice care program are very difficult and often times very frightening. They realize that the patient’s prognosis is poor and that they are entering the final stages of life. Patients and families are generally entering a time of Anticipatory grieving. So many questions regarding hospice exist especially related to the type of care and support services that will be provided to both the patient and the family. Case Managers are in an excellent position to be solid advocates and managers for facilitating this entire process and support high quality and cost effective outcomes in hospice care.

Very often, the first step in the process for patients’ and families is determining when hospice care should be considered. Good hospice care programs focus on relieving, rather than curing, a terminal patient’s physical symptoms. Hospice also provides support for patients as they cope with the emotional and social facets of dying. There are several situations in which patients and families may contemplate using hospice care. It is important that case managers educate patients and families on the total array of services that hospice care provides. Many have the misconception that hospice care is for pain control only. This is the farthest from the truth, of course. Here the case manager may play a critically important role providing more detail as to the many services and benefits that are available such as coordination of physician services and communications, RN home visits and pain control, the availability of nursing assistants in the home, grief counseling services, coordination of clergy visits and spiritual counseling, as well as insurance benefits consulting.

Often, your health care provider will refer you or your family member to a hospice program. He or she will typically make the suggestion when the patient has a life expectancy of fewer than six months. Hospice care frequently takes place in the terminal patient’s home, but in appropriate circumstances can also be offered at hospitals, nursing homes, and dedicated hospice centers. Here case manager’s work closely with insurance companies and government payers to insure that the patient meets the necessary criteria for hospice care and that the care will be covered appropriately under the patients plan. Case managers having education and expertise in managed care can also help insure that he patient is getting all of the available resources provided in their insurance plans.

If your health care provider does not mention hospice or if you initially refuse the option, you may find yourself considering it at a later stage. For example, terminal patients whose families are caring for them at home may worry that they have become burdens. At the same time, family members may experience “compassion fatigue” and need some respite in order to recharge their own batteries. Hospice volunteers can provide this respite in the patient’s home or in another care setting.

Respite care is a wonderful hospice benefit and case managers can be real advocates for families when respite care is critically needed for the family. Case managers by their education and training are able to assess the family’s status for the need for respite care or make arrangements for such assessments with behavioral health professionals.

In addition to offering palliative physical care, professional hospice workers act as an emotional support base for the dying person. Death does not have to be a traumatic experience, but the process usually brings up strong feelings, desires, and concerns. Hospice care helps terminal patients experience their emotions with honesty and courage. It also helps them face tough spiritual questions that may arise as the end of life nears.

Hospice also provides social support for patients with a limited life span. Loneliness, anxiety, and anger are all natural parts of the dying process. It helps to have experienced professionals who can provide a listening ear and practical advice for day-to-day coping. It also helps to connect with other terminal patients in support groups, counseling sessions, or recreational activities. Families often find that the hospice model of care was just as supportive and therapeutic for them as it was for the dying patient. Over many years I have personally been told by countless families of the wonderful support and experiences and “blessings” that hospice provided to them and their dying family member during their time of crisis and the patients passing. It is not uncommon to learn that a hospice nurse, a social work, a case manager, or several from the hospice team will attend the calling hours or funeral when the patient dies. Bonds are formed between the team, the patient and the families when working together in such a highly emotional environment and situation. This is just the nature of the hospice model of care.

Another incredible benefit of the hospice model of care is the on-going support to the families after the passing of the patient. Most hospice models of care provide for follow-up contact with the families on some type of on-going schedule and can provide them, as needed, referral services for grief counseling or other needed support services. Many hospices also provide an annual sponsored memorial service in which they invite families of their patients to come and join in a special service to memorialize all of their patients over the past year. As such, case managers can emphasize to families and the patients that there is continued support beyond the immediate care of the patient.

Hospice care may or may not be the right choice for you and your family. Most people find that at least some aspects of hospice care are greatly beneficial to helping manage the dying process. Before making a decision, discuss your options with your care provider and family members. Case managers play a critical role in hospice models of care today. They are educators, coordinators of care, and advocates for the patient and their families and can be very influential in assisting patients and families in better understanding the hospice model of care so that sound decisions about care in the final stage of life can be better made.

Interested Health Care Professionals who would like more information on our Case Management Continuing Education program, leading to Certification and Fellowship, may access information by clicking here.

Additional Resources

American Academy of Palliative and Hospice Medicine: Click Here

Creating an Effective Hospice Plan of Care: Click here

Is Hospice a Place Where One Goes to Die?: Click here

What is Hospice Care by The American Cancer Society: click here

Healthcare Manager Certification Article on Nursing and Adequate Supply

Supply is important for any hospital or healthcare department.  Supplies are critical for nurses to perform their duties and ensure patient health and safety.  With Covid, these supply lines have been challenged.  The importance of inventory is key to good Healthcare Management and keeping a department supplied is critical to success.

Keeping a department in healthcare supplied is key to patient health and nursing success. Please also review AIHCP’s Healthcare Manager Certification

 

The article, “How Hospital Supply Chains Impact Nurses, Patient Safety, and Margins”, from Managed Healthcare Executive Staff looks at some statistics and facts regarding supply needs and how it affects every aspect of care.  The article states,

“Nurses face significant supply chain management problems that impact efficiency, patient safety, and hospital margins, according to a recent survey from Syft, a leading national provider of healthcare inventory control and end-to-end supply chain cost management software and services.”

To read the entire article, please click here

Please also review AIHCP’s Healthcare Manager Certification.  The program is online and independent study and open to qualified professionals.  Also please review AIHCP’s Healthcare Case Management Program which is also online and independent study.  Both programs lead to four year certifications.

Healthcare Case Management Certification Article on Technology and Healthcare

Since Covid 19, the pandemic has forced telehealth into new unchartered waters but to continue the advancement in delivering high quality patient care, technology and healthcare must continue to work together well into the future.  Accessing rural and other hard to reach patients is a imperative as well as being able to supply high quality care to patients who lack technological support.

Future technology will make telehealth more critical and everyday. Please also review AIHCP’s Healthcare Case Management Certification

 

The article, “How Healthcare Organizations Can Break Down Barriers to Care” by Zafar Chaudry looks closer at how technology and healthcare can closer align for better patient care.  He states,

“These efforts impact every aspect of healthcare, especially the patient. Digital initiatives have made it possible for healthcare providers and patients to connect while maintaining social distancing, just as similar transformation efforts have enabled work from home for many industries and remote schooling for students. But there has been a downside to this trend. Many people don’t have the tools or the infrastructure in place to support remote connections.”

To read the entire article, please click here

Strengthening these connections between technology and healthcare will be a key trend as the future of healthcare continues to serve patients in ways never thought before.  Case Managers will no doubt also benefit from these abilities to better communicate with patients they could not monitor as close before due to logistics.

Please also review The American Academy of Case Management’s Healthcare Case Management Certification.

Healthcare Case Management Certification Article

Healthcare management is a key element in providing quality healthcare.  Unfortunately, the United States and its healthcare system ranks very low in comparison to other industrialized nations.  This has led to the necessity of utilizing healthcare managers to help provide better delivery of healthcare systems by a better understanding of healthcare data and its delivery, population health, competencies of professionals, and care coordination.

Better delivery and outcomes for healthcare are the product of good case management. Please also review AIHCP’s Healthcare Case Management Program

 

The article, “Managed Care-A Plan to the Future” by Patricia Kirkpatrick looks at the critical importance of Managed Care for the future of Healthcare in the United States.  She states,

“Value-based care is here to stay. By developing specific competencies in quality, population health, care coordination, data analytics, governance and care delivery, MCOs can empower their workforces to meet the challenges and opportunities presented by this new model—and ultimately improve health care outcomes for all.”

To read the entire article, please click here

Please also review the American Academy of Case Management’s Healthcare Case Management Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Case Management

Healthcare Case Management Article on Readmissions

Readmissions is a big issue in Healthcare management.  It is not only important to reduce readmissions for the overall health of the person but also to reduce penalties that limit Medicare funding.  Many hospitals suffer from too high readmission rates and it is critical that hospital management encourage safe and efficient practices to reduce readmissions.  Case Managers can play a big role in reducing unnecessary readmissions.

Good article on readmissions. Please also review AIHCP’s Healthcare Case Management Program and see if it meets your academic and professional goals

 

The article, “Understanding your Readmissions: How to Reduce Penalties” by Marie Stinebuck looks closer at ways to reduce readmissions.  She states,

“Hospitals already suffering from the financial hemorrhage of the COVID-19 pandemic will be hit again by the readmission penalty. More than 2,500, or 83 percent of hospitals in the U.S., will receive reduced Medicare funding for the 2021 fiscal year because of their readmissions from 2016 to 2019.”

To read the entire article, please click here

Please also review AIHCP’s Healthcare Case Management Program and see if it meets your academic and professional goals.  The program is online and independent study and open to healthcare professionals seeking a four year certification in Healthcare Case Management