Primary care can lower higher healthcare prices by diagnosing potential problems before they become acute. Regular primary care visits and checkups can perform the preventative measures that can help a person distinguish between healthy and unhealthy choices. Regular blood work and physical checkups can spot early issues that can lead to more expensive treatments later. Primary care can play a large role in better health and less cost.
The article, “How Primary Care Can Help Lower Healthcare Costs” from UniCare State Indemnity Plan,Brand Partner, looks more closer how primary care can play a key role in lowering healthcare costs. The article states,
“Whole health is not only about your physical health, but the behavioral, emotional, and social factors that affect your overall well-being. Non-clinical factors like access to nutritious food and reliable transportation, personal finances, and social isolation can determine up to 80 percent of health outcomes. Primary care physicians (PCPs) are well positioned to help their patients better understand and manage such drivers of health – think of them as the quarterbacks of healthcare.”
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 professionals seeking a four year certification in Healthcare Case Management.
An important aspect of healthcare case management is post acute care. Post acute care is important because it follows the care and follow ups needed after a hospital admission. This is pivotal in lowered hospital readmissions that would not be necessary if better follow up care was provided. Working with post acute care providers is essential to ensure better quality care for the patient over the long term. Healthcare Case Managers play a key role in coordinating care after illness and during recovery to ensure the proper follow-up care is fulfilled and met. They arrange and help the patient find the proper facility to meet their recovery needs as well as help the patient receive the proper follow up treatment.
The article, “5 keys to effective post-acute care management” by Page Minmyer looks closer at better post acute care practices. She states,
“Effective post-acute care management requires a multidimensional approach that incorporates effective communication, data analytics and clearly defined care coordination roles, according to a new white paper from Leavitt Partners. The benefits, however, are clear, as better post-acute care management can reduce readmissions, allow providers to more easily manage length of stay in skilled nursing facilities and better monitor discharge.”
“5 keys to effective post-acute care management”. Paige Minemyer. Fierce Healthcare. May 4, 2017
The field of healthcare case management is concerned with the coordination and delivery of care to patients with chronic or complex health conditions. Case managers work with patients and their families to develop a plan of care that meets the unique needs of each individual. They also work with other members of the healthcare team to ensure that all aspects of the patient’s care are considered and that care is delivered in a coordinated fashion. This process can help to improve patient outcomes by making sure that the care they receive is timely and appropriate. Additionally, healthcare case management can help to reduce the overall cost of care by preventing duplicate services and avoiding unnecessary hospitalizations.
Post Acute Care
In regards to post acute care, the process is even more important in reducing readmissions. Post-acute care is a type of medical care that is provided to patients who have been discharged from the hospital but still require some level of medical care. This type of care can be provided in a variety of settings, such as skilled nursing facilities, home health agencies, or inpatient rehabilitation facilities. Post-acute care is to help patients recover from their illness or injury and return to their prior level of functioning. The goal of PAC is to help patients transition from the hospital to their homes or another care facility, such as a nursing home. PAC typically includes a variety of services, such as skilled nursing care, physical therapy, and occupational therapy.
Care managers also ensure the patient finds the proper facilities. Post acute care facilities provide medical and rehabilitative care to patients who have been discharged from the hospital but still require close medical supervision. These facilities typically offer a wide range of services, including skilled nursing care, physical therapy, speech therapy, and occupational therapy. patients in post acute care facilities often have complex medical needs that require close monitoring and coordination of care.
Types of Post Acute Care
Post Occupation Therapy is the process of helping people return to their previous level of functioning after an injury or illness. This can involve helping them regain their strength and mobility, as well as their cognitive and emotional well-being. Quite similar is physical therapy. Post-acute care physical therapy is a type of PT that is focused on helping patients recover from a serious injury or illness. This type of PT can involve working with patients who are in the hospital, as well as those who have been discharged and are receiving outpatient care. The goal of post-acute care physical therapy is to help patients regain their strength, mobility, and independence.
Through these therapies, checkups, and follow ups, patients can find the acute care they need after their initial stay in the hospital. Care Managers can arrange and help the patient find the proper facilities or therapies for their particular needs and also work with the insurance companies in paying for this type of necessary care. In the meantime, these type of post acute cares can prevent relapse or costly readmissions into the hospital.
In conclusion, case management is a vital role in the health care industry. Without case managers, patients would not receive the proper care and attention they need. Case managers are there to help patients every step of the way, from diagnosis to treatment and beyond. If you or a loved one is in need of health care, be sure to ask for a case manager. They can make all the difference in getting the care you need. In regards to post acute care, case managers play a vital role in coordinating post-acute care. They are the link between hospitals, patients, and families during a time that is often filled with uncertainty. By educating themselves on the different types of post-acute care options and communicating effectively with all parties involved, case managers can ensure that patients receive the care they need to recover successfully.
Please also review AIHCP’s Healthcare Case Management Certification and see if it matches your academic and professional goals. The program is online and independent study and open to qualified professionals seeking a four year certification in Healthcare Case Management. Nurses and other healthcare professionals are excellent candidates to take the required courses and become eligible for the certification.
“Effectiveness of Multidisciplinary Rehabilitation Services in Postacute Care: State-of-the-Science. A Review”. Janet A.Prvu, et, al. Archives of Physical Medicine and Rehabilitation Volume 88, Issue 11, November 2007, Pages 1526-1534. Access here
“Postacute Care Preparedness for COVID-19Thinking Ahead”. David C. Grabowski, PhD, et.al. JAMA. 2020;323(20):2007-2008. doi:10.1001/jama.2020.4686. Access here
“Successful Management of Post-Acute Levels of Care”. Rebekah A. Koutny, RN, BSN, CCM, MCG Nurse Editor, and Carrie Brockman, BSN, RN, ACM, MCG Senior Nurse Editor. MCG Community. Access here
“Post-acute Care for People with Cancer”. American Cancer Society. Access here
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.
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.”
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.
Chronic care for those recovering from heart failure need a variety of social aspects that go well beyond the office visit at the clinic. Care involves also touching base with family care givers and the promotion of better healthy lifestyles and a fulfillment of diet and medical plans necessary to recovery. Case Management plays a big role in watching the overall recovery effort and helping the chronic condition become better.
The article, “Chronic Care Must Account for SDOH Needs, Family Caregivers” by Sara Heath states,
“Nearly 6.5 million people across the country have been diagnosed with heart failure, a disease that can be manageable with medications for some time but hinge on an ideal set of living circumstances to help the patient thrive. Central to that are the social determinants of health, or social factors that affect a patient’s ability to achieve wellness, and family caregivers. Both factor deeply into the patient journey and demand more attention going forward, AHA wrote in its two policy statements.”
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.”
Good article related to healthcare and case management
The article, 3 WAYS TO OVERCOME CHRONIC CARE MANAGEMENT ADOPTION BARRIERS, by Christopher Cheney states,
“While most physicians surveyed recently saw a need for chronic care management services, barriers to adoption include patient skepticism, doctor unfamiliarity with Medicare reimbursement, and physician concern over complicated coding.”
Good article for those interested in the healthcare management fields.
The article, How hospitals can know when to outsource revenue cycle management, by Jeff Lagasse states,
“Revenue cycle management can be a tricky beast, and whether to seek help from an outside vendor is a question with which many health systems struggle. While it may not be the best fit for every hospital or system, there are certain signs that using a third party may be the way to go — and looking at key performance indicators can often be what tips the scale.”
Good article on the importance of preventative care and how it can save institutions financially when it is employed properly through case management but also where in cases it is not always true
The article, Preventive Care Saves Money? Sorry, It’s Too Good to Be True, by Aaron Carroll states,
“The idea that spending more on preventive care will reduce overall health care spending is widely believed and often promoted as a reason to support reform. It’s thought that too many people with chronic illnesses wait until they are truly ill before seeking care, often in emergency rooms, where it costs more.”
The article, “4 Key Ways to Improve Healthcare Revenue Cycle Management” by Jacqueline Belliveau states,
“There is always room for improvement” should be healthcare revenue cycle management’s mantra. Declining claims reimbursement rates, the shift to value-based purchasing, and evolving health policies keep revenue cycle leaders constantly seeking new strategies for improving the financial health of their practice or hospital.”