Case Management Advisor articles from July 2003

Case Management Advisor archives from July 2003

Health plan tailors medical management programs to individual organizations: data-driven program helps develop solutions across the continuum.
July 1, 2003... By identifying the most costly conditions for the health plan and for specific employer groups, Regence Blue Cross Blue Shield of Oregon (BCBSO) has been able to tailor its medical management programs to fit individual organizations and bridge...

DM program targets low back pain; goal: save costs, improve patient quality of life.(disease management)
July 1, 2003... Low back pain is the second most frequent reason for physician visits, the fifth most frequent reason for hospitalization, and the third most frequent reason for surgical procedures. That's one reason CIGNA Health Care, based in Bloomfield,...

Plan identifies, plugs gaps in DM programs: pilot project focuses on severely ill.(disease management)
July 1, 2003... At Oxford Health Plans based in Trumbull, CT, 3% of its members accost for half of the plan's medical costs. The plan, which covers 1.6 million people in New York, Connecticut, and New Jersey, launched an initiative to identify barriers to...

Concentrate on those who will benefit the most: HMO moves to reduce cost of health care.
July 1, 2003... By concentrating its disease management efforts on members who are likely to benefit most, an Indianapolis-based HMO hopes to keep its members healthier and reduce costs to employer groups at the same time. "The bottom line is that health...

Correcting medical errors: how far do you go? CMs have a responsibility to monitor errors. (Guest Column).
July 1, 2003... The occurrence of medical errors made by health care providers against patients has been at the forefront of the media in recent years. Dealing with the occurrence and subsequent outcomes of medical errors is a hazardous part of our jobs, but...

CE questions.
July 1, 2003... 1. When Regence Blue Cross Blue Shield of Oregon analyzed claims data, the insurer found that--account for half of their spending? A. Diabetes, congestive heart failure, stroke, and asthma B. Heart disease, cancer, gastroenteritis, and...

New BP guidelines establish diagnosis of pre-hypertension: level seeks to identify at-risk individuals early.(Brief Article)
July 1, 2003... New clinical practice guidelines for the prevention, detection, and treatment of high blood pressure have been released by the National Heart, Lung, and Blood Institute (NHLBI) in Bethesda, MD. The guidelines, approved by the Coordinating...

New AHRQ tool checks patient safety performance.(Agency for Healthcare Research and Quality)(Brief Article)
July 1, 2003... The Agency for Healthcare Research and Quality (AHRQ) has developed a new web-based tool that can help hospitals enhance their patient safety performance by quickly detecting potential medical errors in patients who have undergone medical or...

IOM seeks improved training to improve quality of care.(Institute of Medicine)(Brief Article)
July 1, 2003... Changes are needed in the education of physicians, nurses, and other health professionals to improve patient safety and quality of care, according to a new report by the Institute of Medicine (IOM) in Washington, DC. For example, the IOM...

JCAHO revises scoring for one of its patient safety goals.(Joint Commission on Accreditation of Healthcare Organizations)(Brief Article)
July 1, 2003... The Joint Commission on Accreditation of Healthcare Organizations has changed how it scores organizations on its National Patient Safety Goal to eliminate wrong-site, wrong-patient, wrong-procedure surgery. The goal includes a recommendation...