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.
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. ”
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.
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.”
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 article on value based care and how it can help drive preventative care. In fact, patients in a value based care model benefit greatly in preventative care practices. Through various models, education and teaching can help patients understand their own diagnosis and recovery to prevent future issues. This type of model is very beneficial to any organization and it is of no wonder that these value based care models correlate with better preventative care with patients.
The article, “Value-Based Care Drives Preventive Care, Care Management” by Sarah Heath explores this reality and delves into greater detail how value based care models are very beneficial for patients. The article states,
Patients receiving care from a doctor in a value-based care model tend to experience better quality care, receive more preventive care, and yield higher medication adherence and adherence to chronic disease management plans, according to a new report from Humana.
A certified Case Manager also is well versed in these areas of study and makes an excellent candidate to help implement various value based care models. Pleas also review our Healthcare Case Management Program to see if it matches any of your academic or professional needs. By taking the core courses in Case Management, qualified professionals can earn a certification in Case Management with AIHCP and apply the skills to their profession.
As long as readmissions are high, the cost of healthcare will be high, so it is important to reduce readmissions for this financial purpose alone, but also for the overall health and recovery of the patient which can be lost in the game of cents and dollars