Good article for those interested in healthcare and healthcare related areas.  This article looks at putting health back at the forefront of healthcare and how healthcare professionals can play a pivotal role in making this common sense simple idea work again.  Please also review our Healthcare Case Management Program and see if it matches your academic and professional needs

The article, Here’s a Crazy Idea: Put Health at the Center of Health Care, by Clifton Leaf states,

“A decade ago, doctors Tom Frieden and Farzad Mostashari wrote a commentary for a leading medical journal entitled, “Health Care as If Health Mattered.” The essay, published in JAMA (sorry—it’s behind a paywall), had a simple, if obvious, premise: “Health care must be restructured to make maximizing health the organizing principle.”

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Good article for certified case managers.

The article, “3 Pain Points Affecting Small Practice Healthcare Revenue Cycle” by Jacqueline Belliveau states,

The article, “Why is Your Health Insurance So Expensive?”, by  Sandra Mills states

“When we think of insurance, be it homeowner’s insurance, car insurance, or health insurance, we initially think of the accumulative money we’re healthcare 6 going to be dishing out every month.”

See on www.bhmpc.com

How Can Case Management Help Understand Health Insurance?

With so many types of health insurance out there, finding one for you and your family might be tough. Ask a case management nurse can be very helpful.   In the case of a medical emergency, that little card can literally be life-saving. This article provides case manager health insurance tips that can benefit you.
Catastrophic health insurance coverage, as explained by case management professionals, is an option for individuals that cannot afford a standard health insurance policy. Catastrophic coverage will protect you in case you experience a severe, life-threatening illness or an unexpected accident of injury. This kind of coverage is also good to add to an overall health care plan as extra coverage when there are extreme circumstances.
Ask your doctor to increase the dose of your prescription to save a few bucks. Often, buying pills in larger doses does not significantly increase the cost so you may be able to save money by cutting the pills in half. This can actually pay for your pill splitter.

Watch your bills, suggests nursing case managers. Even if you have a good health plan, you might get charged for items that will surprise you, such as prescription medication. Some doctors don’t think of generic (and cheaper) versions of medications, and just prescribe the brand name medicine. Don’t hesitate to compare prices as well. The price of the same medication can vary widely at different pharmacies.
The premiums on health insurance are not rigid; consumers can decide what will and will not be part of their benefit plans. For example, you may exclude things like prescription coverage, vision and dental coverage or co-payments on doctor visits. Keep in mind that the more benefits that you chose to have the higher your premium will be and the less benefits the lower your premium.
Health insurance policies often times include different incentives to help you stay healthy. Many health insurance companies now offer discounts on gym memberships, annual medical checkups, quit smoking classes, weigh loss plans, healthy eating classes and annual flu shots. In addition, your premiums may be lowered if you take advantage of these opportunities to save.
If you are qualified, you can get a medical care card at discount, which could give you lower cost insurance coverage from your insurer. This card allows you to go to a doctor in their network that offers reduced cost healthcare for those with low incomes. In some cases, you can even obtain health spending accounts that give you additional ways to take care of your costs.
In the end, it is cheaper if you have a group plan, that is why you have cheaper premiums if you work for someone. The best way to get around this is to become a member or a trade organization that has insurance available to its members.
Raise your deductible to find more affordable premiums for health insurance. If you will increase your deductible, you can significantly lower your health insurance premium. Keep in mind that although your premium will be lower, you must spend more each year before your insurance will pay part of the costs.
If you require health insurance and have are a recent college graduate, there are some things for you to think about. If you’ve got a job, use the employee-based insurance it provides. You can also be listed under your parents’ policy until you turn twenty-six, or look into personal plans.

No matter what, you will save money by buying generics over brand name drugs. Generics are available in most cases and contain the exact same ingredients as a brand name.   Check with a nurse case manager to find out the list of generic drugs you can take.
Check with your health insurance carrier to know what prescriptions are covered under your policy. This list will be different every year or so, so make sure you check it when you enroll again to avoid a surprise at the pharmacy when filling your medication.
The first thing to do is find a suitable company when you apply for health insurance. Another organization is a Preferred Provider,(PPO) which has their own network to pick from; they will allow you choose a doctor from another network, although there is a fee involved. A POP or Point-of-Service plan lets you pick a PCP, but they’re allowed to refer you outside that network.
If issues with your vision have arisen, or if there are hereditary factors that could cause problems in the future, consider an insurance policy that covers vision. The insurance will likely cover some of the cost of doctor visits as well as a portion of costs related to contact lenses and glasses. Insurance for vision is not required, and many people forgo this option to save money.
Are you currently covered under a health insurance policy? Having the right health insurance will ensure that you or your loved ones will receive the care that they need regardless of what situation arises. You can use the advice that this article has provided to you to ensure that you and everyone you love has proper coverage.
By Rick Popovici

Case Management

We are witnessing a growing trend in health care delivery. Providers of health care and insurers are starting to work together more closely to improve the quality of care and hold down unnecessary costs. This is not totally new as such processes have been in place for a long while through nursing case management systems, albeit sometimes in adversarial postures. What is new is that executives are finally understanding better the need for collaboration and cooperation in the delivery of care. This article is an example and provides promising insights.
By: REED ABELSON
The New York Times
Access article: click here
To learn more about case management certification programs, click here.

I have pretty much always known what I wanted to do with my life and I never. At first I wanted to get into social services and help get children out of abusive homes and bad situations and the like. Then I realized I had need to get more personal with these people. To really affect and have a positive impact on their every day lives after incidents like these occurred. That is  

when I started studying to become a case worker. Getting your case manager certification is not an easy task, but with a little research and some good old fashioned studying, you won’t have a problem. Some psychological classes are involved but they were not really anything I have not been through before. All in all, getting my certification was a fulfilling experience that I will never regret, and now, because of it, I have the job of my dreams! I am one of few people who would not turn back time if given the chance.

In the medical field, many people can be involved in your health care and recovery. It can get confusing trying to figure out who to talk to about what. Case management has made that easier. The case manager is the person responsible for assessment, planning, facilitation, care

coordination, evaluation and advocacy for options and services to meet and individuals and family’s comprehensive health needs. The do their job through communication and available resources to provide quality cost effective outcomes. They plan, seek and monitor services for different social agencies and staff on behalf of the client. The do this in four steps. First, they get the referral of a new patient. The case manager then develops a plan for delivery of care. They evaluate the results for each patient and make adjustments where needed. Finally, they evaluate the overall program effectiveness. They function in several different areas. In the health care and HMO setting, their duties may include checking benefits and negotiating rates along with many other duties. In the health care provider setting, they will verify original benefits, coordinate services and provide post care follow-up but that is just a taste of their duties in that area. In the employee setting, they verify medical reasoning, follow-up after work absences and provide health education.

One of the main purposes of case management is to help the patient with improving the quality

of their lives. It is a process by which a social service agency’s worker is assigned and can assist the patients and their families in connecting with the resources needed for their health care needs and helping them to navigate through the social service systems. Their role is to advocate on behalf of their patients and assist other medical providers with understanding the needs of the patient. With a good case manager handling the case, the collaborative process is made much easier because the patient’s voice and their decisions is the essential key. In order for the case manager to properly execute the required services, they will have to create a plan that will guide them and their patients through the overall process. One of the first steps in this planning process is meeting with the patient.