Hospital Case Management

The Case Management program is offered by Kaiser Permanente to support members with complex medical, psychosocial, and care management essentials. This specialized service is provided by case managers. The case managers are either Registered Nurses who are certified in case management or qualified Social Workers. Case managers provide necessary information and education to promote understanding, reduce the chance of possible complications, and facilitate effective and proper delivery of care and services.

How does case management achieve efficiencies in the delivery of health care? How does case management differ from disease management?

Case managers play such a key role in the health systems that they are almost considered as the face of patient care.

Case management has case managers who effectively assess my healthcare needs. They also provide support systems to help me. Then, they coordinate, monitor, and evaluate my progress and the services that I receive. It promotes quality and cost-effective interventions and outcomes.

The Camden Coalition of Healthcare Providers is built on a partnership between with active participation from 3 Camden hospitals, 2 Federally Qualified Healthcare centers, private community-based medical practices, social service agencies and the patients and community at large (Miller, Cunningham, & Ali, 2013). The main goals are improving care for “super-utilizers” while bending the cost curve (Miller et al., 2013). A “super-utilizer” is a person who overuses emergency departments and hospital inpatient services, making more visits to those facilities in a month than some people make in a lifetime (Camden Coalition of Healthcare Providers [CCHP], 2015). Also referred to as “frequent users” or “frequent

Today almost every major health care organization has a case management program managing and directing the use of health care services for their clients. Also, case management by payer organization is recognized as external case management (Jacob & Cherry, 2007). Hospitals recognized the need for the case management model in the mid-1980s to manage the lengths of stay of hospitalized patients and the treatment plans (Jacob & Cherry, 2007).

In the case of Jared, he is seeking treatment after being in an inpatient alcohol treatment center. In patient services helped him focus on addressing his addiction to alcohol and what triggers him to drink. Jared can benefit by using outpatient services. Outpatient services will help Jared by giving him more freedom to allow his commitment to family responsibilities at the same time attend his sessions (Erford, 2013). Jared must abstain from alcohol which requires a lot of willpower but outpatient can offer him support groups, individual counseling, and family counseling, so Jared will never feel like he is alone in his recovery.

Diminishing readmission has turned into an order for hospitals over the United States, rushed by execution of open revealing and money related punishments for abundance readmissions. In any case, in spite of a quick need to enhance the nature of release arranging and transitional care, there is restricted superb confirmation illustrating how to best achieve this.

As a reminder, I am interning at Mercy Behavioral Health Service Coordination Unit (MBH-SCU). The unit collectively serves 500 to 700 consumers and includes six teams. Each team includes a supervisor and ten to fifteen service coordinators. Each team aids a specific population, such as adults, adolescents, and children. Initially, I was assigned to the adult’s team, but I do explore all of the teams within the unit.

Out of the 52 recipients who reported funding medical case management as a core medical service, 88% or 46 recipients reported at least one medical case management performance measure. According to the results presented from the recipients regarding information from the medical case management performance measures: 36 recipients reported the use of medical visit frequency, 32 reported data for care plan, and 20 reported data for adherence counseling and assessment.

The General Assembly of the State of Albacore is considering implementing a new bill that could potentially affect the overall workflow at Hospital Bass. The bill will order that at least 30 percent of a hospital’s workforce has to speak Spanish, which includes all hospitals within the state of Albacore. The unfortunate part is that any healthcare facility that does not follow this law will only receive 50 percent of Medicare reimbursements compared to the 80 percent they are now receiving. The issue with this bill for Hospital Bass is that currently only 15 percent of the workforce speaks Spanish, meaning the facility would need to hire twice as many employees once the bill is initiated. Not only would it be a challenge to hire these employees,

Case management as a health care strategy, has experienced increasing attention since it was implemented with managed care in the 1980s and 1990s to control the rising costs of health care (Dunham-Taylor, 2015). When case management is utilized, efforts are initiated to identify and assist high risk, high cost Medicare and Medicaid enrollees and persons with complex conditions, for the transition from hospital to home to provide care in a less expensive setting and avoid unnecessary medical costs (Dunham -Taylor, et al., 2015). As an example, chronic illness such as diabetes mellitus “places a significant burden on the U.S. health care system” (Rubin, et al., 1998). Research has shown that patients with diabetes being treated through various

According to IC & RC, Case Management is defined as, “activities intended to bring services, agencies, resources, or people together within a planned framework of action toward the achievement of established goals. It may involve liaison activities and collateral contacts” (Herdman, John W., 6th Ed.). Case management is a concerted effort of various professionals in the human social services network that assess’, plans, implements, coordinates, monitors and evaluates options required to meet the client’s health and human service needs. It is characterized by advocacy, communication, resource management and promotes quality cost-effective intervention outcomes. The Case Management Process centers on the client and the client’s support system. It is holistic in its approach to the management of the client’s individual and specific situation and that of the client’s support system. It is adaptive both to the case manager’s practice setting and to the healthcare setting in which the client receives services. Case management is not a profession unto itself however; it is a cross-disciplinary and interdependent specialty practice within the health and human services profession. Everyone directly or indirectly involved in healthcare benefits when healthcare professionals and

The purpose of this assignment is to read and review the case study. Then discuss your assessment of Shouldice Hospital 's marketing challenges, as well as presenting your ideas for how the hospital can best manage those challenges. The assignment will contain the answer of the following questions:

The significance of community hospitals such as Community Hospital in Monmouth County, New Jersey, is greater than one may expect for primary and secondary care services provided to the local communities around the United States. Community Hospital’s mission is to provide exceptional primary care. However, with the declination of profitability in primary care, Community Hospital has had to compete with Shore University Medical Center (SUMC) and University Hospital (UH) for revenue restoration. The decline of Medicare and Medicaid reimbursements and the steady progression toward specialty care vs. primary care require a core alteration to the mission statement to adjust to the changes within the current healthcare system. A newly modified mission and vision statement will prove that Community Hospital has the ability to regain its relevance within the healthcare industry as a leading primary care provider in the community and increase its revenue. The implementation of the new mission and vision for Community Hospital is expected to be upheld without compromising the core values of compassion, advancement, reputation, efficiency, and physician integration. A few proposed strategies to help Community Hospital create a new and improved business model, may seem cumbersome and challenging, however could greatly improve the overall direction of Community Hospital.