Service of care should not be the main contributor of reimbursement but quality of that service. Overall population health, patient experience and patient care that reduces unnecessary stay and services are all critical elements.
The article, “Improve patient care – aim for the Triple” by Phillip Gratzel von Gratz looks at the triple aim of patient experience and health. He states,
“There is a broad consensus around the world that healthcare reimbursement should at least partly be based on performance and outcomes and not exclusively on service provision. This is mostly a theoretical consensus though”
Please also review our Healthcare Case Management Program and see if it meets your academic and professional needs. Healthcare Case Managers need to understand the value of patient care in regards to quality and also cost effective ways to treat patients.
Healthcare Case management is an important field for any administration or hospital. It helps track the overall health and needs of patients. It is critical to the success of the hospital as well as to the patients.
Nurses are excellent candidates to become case managers for hospitals. Nurses who have worked at the hospital have a knowledge of the system and can prove to good internal hires by the administration. Nurses with skills in case management can make the switch from the floor to the office very easily. Some positions require some type of formal education to enter into this field. A certification is an excellent way to achieve the education and the confidence needed to fill a position of case management. Most hospitals prefer to have a case manager who is certified. Many hospitals also pay for their nurses or case managers to become certified.
The American Academy of Case Management offers a Healthcare Case Management Certification. This Nursing Case Management focus is an excellent way for nurses to become certified and be able to perform their functions as a case manager. The Nursing Case Management program is independent study and online. After the completion of five core courses, the nurse or student can apply for a four year certification.
Again the courses are independent study and self paced. The courses are completely online. Each course requires a text book and the completion of an open book exam. Students can utilize their instructors as much or as little as they need.
Since Case management such a critical and important aspect to hospital function and patient well being, nurses can become excellent candidates to become case managers. Please review AIHCP’s Nursing Case Management program and see if it matches your academic and professional needs. With the education and training from the American Academy of Case Management, you will be able to face any case management challenges in a hospital setting.
What Do Nurse Case Managers Do?
Nurse Case Managers or Healthcare Case Managers are important parts of the hospital system. A case manager coordinates with various departments regarding the overall health of the patient. The case manager is the record keeper and makes sure all medical professionals are on the same page. They also play a key role in helping recover. In this way, it goes well beyond just the background of the patient and the initial stay but also includes recovery plans.
Nurse Patient Educators can play an important role with the Case Manager in ensuring the recovery and overall health of the patient. This reduces re-entry to the hospital and cuts down price. In this way, nurse case managers play a big role in outcome base statistics.
If you find interest in the case management field, please again review the American Academy of Case Managements information and see if it meets your professional goals and needs.
Great article on lowering readmission. Readmission is a huge problem for many institutions. It is not only financially good but also poor for overall patient health.
The article, “Patient Engagement Strategies That Prevent Hospital Readmission” by Sarah Heath looks at how better patient engagement can lower readmission. She states,
“Hospital readmission is a key metric in the value-based care landscape, with many programs looking for organizations to lower their readmission rates in an effort to cut healthcare costs. Using strong patient engagement strategies, organizations can move the needle on hospital readmission rates.”
Good article looking at the benefits but also costs of medicare. With healthcare always a central topic in politics, the idea of medicare for all is a big conversation. Some say it will save while others say it will cost too much.
The article, “Would ‘Medicare for All’ Save Billions or Cost Billions?” gives one opinion on the subject. The authors JOSH KATZ, KEVIN QUEALY and MARGOT SANGER-KATZ state,
“How much would a “Medicare for all” plan, like the kind being introduced by Senator Bernie Sanders on Wednesday, change health spending in the United States? Some advocates have said costs would actually be lower because of gains in efficiency and scale, while critics have predictedhuge increases.”
Maximizing efficiency is a key element of case management, especially healthcare case management. Results with better health is superior to paper work.
The article, “Four Ways to Empower Your Care Managers to Focus on Results, Not Paperwork” sponsored by HMS and Fierce Health Care states,
“Today’s care managers face a variety of challenges with many handling a higher volume of complex patient cases than ever before. At the same time, value-based care delivery and reimbursement models demand that care managers keep a close eye on healthcare costs while still managing their day-to-day.”
Technology is important in healthcare but without trained professionals using it, it has no value. This is why it is so important to have good, trained and caring professionals behind all technology. Only with both, can healthcare make a difference
This is especially true with chronic pain management. The article, “When it comes to chronic care management, tech can’t replace people” by ERIN DIETSCHE states,
“Technology has become increasingly common in the healthcare arena. The story isn’t any different in the chronic care management space, as companies like Livongo and Omada Health leverage tech to assist patients. But a new survey found humans are just as important as trendy IT tools.”
Care coordination is key to patient outcomes. Good coordination between caregivers and care teams improves mental and physical health of patients.
The article, “Care coordination improves mental and physical health outcomes” from the Cleveland Daily Banner states,
“The Tennessee Association of Mental Health Organizations which represents 20 community mental health centers and other nonprofit behavioral health care providers, announced results from the first year of the Tennessee Health Link program, highlighting improved health outcomes for individuals and improved cost control for the state through better coordination of behavioral and physical health services.”
With higher and higher drug prices, who is really to blame? It is hard to tell sometimes but the article below looks to answer why these prices continue to seem to increase.
The article,”High drug prices: Who’s really to blame?” by Susan Morse states,
Reaction to the proposal has varied. America’s Health Insurance Plans and pharmacy benefit managers say it’s the drug manufacturers that set the prices, and it’s hard not to point the blame at pharmaceutical companies when prices for orphan drugs to treat rare diseases have sometimes increased by thousands of dollars, for no obviously perceivable reason.
Good healthcare is gold to many Americans but how much are they willing to sacrifice for it? Many nations have free healthcare with higher taxes, while others play high rates for the best plans.
The article, “How Much Will Americans Sacrifice for Good Health Care?” from the New York Times states,
It’s been nearly 10 years since the passage of the Affordable Care Act — one of the most sweeping health care overhauls in the nation’s history. The law has brought the number of uninsured people in America to an all-time low, secured protections for people with pre-existing conditions and advanced the notion that health care is a human right.
Bipartisanship is key to reforming healthcare, but as long as division exists, no true gains will be made.
The article, “Paving a Bipartisan Path on Health Care Reform” by Richard Nathan discusses how reforms can be found if people work together. The article states,
Can we overcome the polarized politics of health care and find a way forward? I believe we can. From my days as research director for President Lyndon Johnson’s National Commission on Civil Disorders to my time in the Nixon administration, my work at the Brookings Institution to my service with the Manpower Development Research Corporation and the Rockefeller Institute of Government, I have spent most of my career as a public administration scholar-practitioner working with leading state and federal lawmakers, governors, and presidential candidates in both parties.