Some of the most expensive patients in healthcare are dealing with homelessness and addiction. These factors contribute to the patients not finding immediate resolution of the issue, as well as frequent re-admissions. This results in higher prices and more difficult coordinated healthcare care management. Case Managers find themselves in difficult positions trying to help the patient find a permanent resolution to the medical issues experienced.
The article, “These Patients Are Hard to Treat” by Reed Abelson looks at these two types of patients and better ways to help them and also reduce cost. She states,
“These individuals, frequently struggling with addiction or homelessness, have extremely complicated medical conditions. By finding them and connecting them to the right doctors and social services, dozens of costly hospital stays could be avoided. The idea has been adopted in numerous communities around the country.”
Please also review our Healthcare Case Management Certification. The program is online and independent study and can help prepare medical professionals for the field of case management. Please review the program and see if it matches your academic and professional goals.
Success within the healthcare market can be a challenging thing. Healthcare professionals and healthcare organizations have stiff competition but by meeting primary goals they can meet success and carry on a successful model for patients, employees and overall health of the community.
The article, “Defining Success in Healthcare” by Keith Loria looks at some things that determine the success for those involved in healthcare. He states,
“Success in these measures will be defined by stakeholders including patients, providers, and employers having a better understanding and view of their healthcare costs; stable or reduced costs of healthcare that patients and employers actually feel through premiums and cost share; and improvement in the perception of health plans and PBMs by the public,” says Jeremy Schafer, PharmD, senior vice president of New York-based Precision for Value, a group of consultants providing payer insights”
One important and critical element to success in healthcare is good case management. Case and care managers can help patients through admission to recovery increasing positive patient experience and reducing costs for the clinic or hospital. Please review the American Academy of Case Management and its Healthcare Case Management Certification. The program is online and independent study, open to healthcare professionals looking to enter into the case management field.
Care Management is crucial to patient health and recovery as well as cost saving elements within an institution. Care management is key to these elements and case managers play key roles in maintaining standards of quality that benefit both patient and hospital.
The article, “3 Strategies to Transform Care Management” by Jessica Scruton reviews three ways that one can transform care management. She states,
“Care coordinators or care managers are the foundation for any accountable care organization (ACO) or other such integrated delivery networks for managing patient populations. Robust, integrated and artificial intelligence-powered information technology is certainly essential for helping these teams work efficiently and productively.”
Care coordinators are a critical element in healthcare and care management. To read the entire article, please click here
Better care management and value based payments creates better control over opioid abuse. Care Management can play a key role in this endeavor in curbing this current epidemic.
The article, “Value-Based Payment Opens Doors for Better Opioid Use Disorder Care” by Jacqueline LaPointe looks at this situation. The article states
“We have about a 90 percent treatment gap in this country, and it’s really important for people to wrap their minds around that. People are presenting in a lot of places where care is not offered to them and until we transform the payment model, we’re not going to be able to close the addiction treatment gap”
Healthcare continues to be a growing cost for the average American as well as the average employer. Employers on average according to a latest poll are paying around $13,000 an employee a year. With the cost continuing to rise, it is becoming more and more expensive to give people the basic care they need. With healthcare such a huge issue in the 2020 election, it will be interesting to see who has the solutions and who does not to combat this ever growing national issue.
The article, “Companies Move to Limit Employees’ Health Costs: bt David McCann looks at some statistics illustrating the growing problem with healthcare costs. He states,
“The average total health benefit cost per employee grew 3.0% to reach $13,046, following a rise of 3.6% in 2018. This is the eighth consecutive year of health benefit cost growth in the low single digits, and employers expect the cost to rise at a similar pace next year. Still, cost increases continue to outpace overall inflation.”
Cancer is a very painful disease and it requires management. To manage cancer pain, cancer treatments and palliative care as well as later if necessary hospice care, looks to lessen the pain with pain management strategies. Case managers and a cancer team can put together an effective plant o help cancer patients minimize pain and discomfort during treatment or if on the darker note, a terminal trail.
The article, “Approaches to Cancer Pain Management” by Deborah Abrams Kaplan states,
“Ideally, treating pain involves a multi-prong approach. That might mean some combination of physical therapy, behavioral therapy, blocks/injections, and medication. Not all health insurance covers an extensive approach, though undertreating pain impacts a patient’s health and quality of life substantially. ”
Re-admissions cost the healthcare industry millions. It is important to give the patient the care and education afterwards they need to find recovery and good health. This is an important part of both the Nurse Patient Educator and the Healthcare Case Manager. It is important to ensure quality care, pre and post, and to also ensure the patient has a strong understanding of post care.
Kayt Sukel in her article, “Strategies to Help Reduce Hospital Readmissions for Cancer” reviews some ways re-admissions for cancer can be limited. She states,
“Today, there is pressure to make hospital stays as brief as possible, which means that many patients are discharged without all of their issues being completely resolved. Since cancer is such a complex condition, with both acute and chronic elements, we often see that readmission rates in the cancer population are higher than those in the general medical population.”
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.”