Good article for those interested in Healthcare Case Management.  This article deals with child health strategies.  Please also review our program by clicking here

The article, Role of district health management teams in child health strategies, states

Emergency room visits can be necessary but also costly financially.  This article looks at the cost incurred by average Americans at the ER but also many of the issues Americans face against insurance companies who refuse to pay for the care

The article, As an Insurer Resists Paying for ‘Avoidable’ E.R. Visits, Patients and Doctors Push Back, by Reed Abelson, Margot Sanger-Katz and Julie Creswell, looks at some of these issues and also connects you to other resources to help understand the nature of the ER. It states

Good article for those interested in Healthcare Case Management.

The article, Care Management for Children With Medical Complexity: Integration Is Essential, by Richard C. Antonelli, Renee M. Turchi state, 

“In the report “Effectiveness of a Comprehensive Case Management Service for Children with Medical Complexity,” Simon et al¹ examine the impact of a care management intervention that is based in a pediatric academic medical center on quality and cost outcomes for children with medical complexity (CMC) and their families. Rigorously designed studies like this are important and timely because increased attention is being given to achieving the national strategic priority to improve outcomes for high-resource–using children and youth.”

To read the entire article, please click here

If you would like to learn more about Healthcare Case Management, then please review our certification program and see if it matches your academic and professional needs.

Good article for those interested in Healthcare Case Management.

The article, Single-payer would drastically change health care in America. Here’s how it works, by Kim Soffen states,

Injured on the Job? How Being Injured at Work can Impact Your Healthcare

Being injured on the job has the potential to seriously impact not only your physical health, but also your financial health and well-being. The good news is that state and federal workers’ compensation laws mean that there is a good chance your medical expenses will be covered. In addition, although approximately 75% of workers’ compensation cases only cover medical expenses, you may also be entitled to compensation for lost wages.

Unfortunately, while the workers’ compensation program provides many benefits to those injured on the job, it also has the potential to seriously affect the type and quality of the health care you receive. For this reason, it is essential that you know about the potential impacts to your health care in order to be fully prepared should you be unfortunate enough to experience a work-related injury.

Your Normal Health Insurance Won’t Cover Your Injury
Almost every health insurance policy contains an exclusion for work-related injuries, which means that your normal health insurance won’t cover any medical expenses related to treating injuries you suffered on the job. The reason behind this is that these expenses should instead be covered by your employer’s workers’ compensation insurance. However, your health insurance provider may still be required to pay for your medical expenses should the workers’ compensation insurance deny payment for whatever reason. Of course, it’s always a good idea to seek out workers’ comp lawyers in your area to ensure that your rights are respected.

You May Be Limited in Your Choice of Doctor
Not all doctors and hospitals accept workers’ compensation insurance, which means that you may be limited in your choice of doctors. If your current doctor does accept workers’ compensation insurance, you will still be able to use this doctor in most cases. However, should your doctor not accept workers’ comp, you will usually be forced to begin searching for medical professionals in your area that do take workers’ compensation cases.

You Could Be Forced to Wait for Treatment
Unfortunately, filing a workers’ compensation claim also means that you may be forced to wait longer before you can begin receiving any necessary treatments for your injury. The reason is that all medical expenses generally need to be approved by the workers’ compensation insurer before they can be performed. How this works is that first the doctor must determine whatever medical treatments are necessary to treat your injury. After this, the doctor then sends a request for authorization to the insurer, which then must determine that the treatment is necessary and reasonable before sending final approval back to the doctor. Although the process typically doesn’t take more than a few days, you will still have to wait to begin treatment until this final approval has been received.

American workers’ compensation laws were put in place in order to protect workers and ensure that their medical expenses are covered in case of a work-related injury. While this is definitely a huge benefit to anyone who would otherwise be unable to cover the costs of these medical expenses, it is still important that everyone is also aware of the ways in which a workers’ compensation claim can affect the health care you receive.

About the Author: Lizzie Weakley is a freelance writer from Columbus, Ohio. She went to college at The Ohio State University where she studied communications. In her free time, she enjoys the outdoors and long walks in the park with her 3-year-old husky Snowball.

Please also review our Healthcare Case Management Program

Good article regarding traditional ER’s and clinics.

The article, “The Lines Are Blurred Between Freestanding ERs and Urgent Care Centers”  by Olivia Nguyen states

“Last November in Frisco, Candie and Dustin Sandlin entered a Legacy ER & Urgent Care center—a walk-in clinic that also operates as a freestanding emergency center—because the couple’s primary-care physician was unavailable. Candie, experiencing symptoms of a migraine headache, was told by the on-site doctor that a CAT scan was needed to rule out any serious diagnoses.”

To read the entire article, please click here

If you are interested in Case Management and healthcare, then please review our healthcare case management program

What Provisions are Missing from Your Healthcare Future?

There will be several changes in the medical industry coming soon. The Affordable Care Act is impacting doctors, nurses, and patients with it’s new laws and rules. Many nurses are working fewer hours as a result, and providing quality medical care is becoming a challenge for some. Fortunately, hospitals and clinics will always need nurses and there are many improvements coming along with these changes. Patients should be concerned about their health care plans and what is included in them. A quality health care plan will have the following provisions.

Home Health Care Worker

Many people receive health care services outside of a medical setting, especially as they get older. Home health care workers provide services to people who are temporarily and permanently disabled. A home health care nurse can assist patients with their daily tasks and can also give the patient’s family detailed care instructions. It is always a good idea to include provisions for a home nurse or assistant. Check out programs like United Energy Workers Healthcare for more information on what you may qualify for.

Mental Health Care Services

Some people need mental health care services in their healthcare plan. Before you purchase a health care plan, you should make sure the plan offers coverage for certain mental health care services if this is an issue for you. The plan should offer coverage for inpatient and outpatient treatment centers. Some insurance policies have a separate deductible for mental health care services as well. You should choose a plan that has an affordable deductible for mental health care services.

Chiropractic and Acupuncture Coverage

Some insurance plans do not cover chiropractic and acupuncture services. If you deal with chronic pain, make sure you have services on hand or that are provided for in some way. Some people think that these benefits are not a necessity, but if you ever have a serious injury, you may need chiropractic or acupuncture services and they can be covered.

Pre-existing Conditions Coverage

All medical plans should cover pre-existing conditions. In the past, insurance companies would not insure people who had a pre-existing medical condition. The affordable care act does not allow discrimination based on a person’s current health status. You should make sure that the insurance policy does not permit exclusions based on pre-existing medical conditions.

Preventative Health Care Services

Your plan should offer affordable preventative health care services. Most doctors want to treat a serious medical condition in the early stages of the disease. If your plan has reasonably priced preventative health care services, you can visit your primary care doctor whenever you have a medical problem.

New changes are becoming effective every year, and the changes are impacting individuals and large companies. Your insurance policy is an important purchase. If you have any questions about your policy, you should contact the company for clarification.

Please also review our healthcare case management program

We talk so much about health care that we sometimes forget the most important thing, health itself.  This article goes into this issue deeper and explains somethings about healthcare and health.

The article, “The One Important Thing Missing From the Health Care Debate” by Jeffrey Pfeffer states,

“You may have seen the big news on health care: Aetna is going to stop offering individual health insurance policies on the health exchanges in 11 of the 15 states where it operates. Aetna AET -0.31% follows the lead of another large health insurer, United Health UNH -0.47% , which announced in April that it was withdrawing from almost all of the health insurance marketplaces where it operated.”

To read the entire article, please click here

Please also review our healthcare programs.  We offer a comprehensive healthcare case management program for qualified professionals.