Case Management Advisor articles from March 2003

Case Management Advisor archives from March 2003

Look to your reinsurer for help in managing catastrophic cases; CMs should be aware of reinsurance benefits.
March 1, 2003... You're a case manager for an insurance company, and a spinal cord injury case that needs intensive management and care over a long period of time lands on your desk. You've never handled care for a spinal cord injury patient. Where do you turn...

What are the uses of reinsurance? Insurance for the insurance company.
March 1, 2003... A catastrophic case that involves a lot of coordination of resources, a lot of care planning, and a large allocation of financial resources that may or may not cause the patient to reach his or her maximum lifetime benefit should be a flag to...

Oncology CM vendor improves cancer care; result is healthier patients, lower costs.
March 1, 2003... When the quality management and quality improvement teams at Blue Cross and Blue Shield of Missouri examined the data for each disease, they found that the costs for oncology were increasing at a much greater rate than for other diagnoses and...

Collaboration: key to oncology program: vendor, health plan CMs work together.
March 1, 2003... When Blue Cross and Blue Shield of Missouri negotiated a contract with Quality Oncology to handle utilization management and case management services care for its members with cancer, the health plan insisted that the vendor use the insurer's...

Predictive modeling helps DM company focus on care; managing the population one person at a time.(disease management)
March 1, 2003... Targeting the right members for intensive disease management is the key to a successful program, says Christobel E. Selecky. That's why her company, LifeMasters Supportive SelfCare Inc., spends a lot of time crunching data to predict the...

Regular data aid DM effectiveness; patients self-report via computer.(disease management)
March 1, 2003... When a member of LifeMasters Supported SelfCare's disease management program weighs himself, takes his blood pressure, or blood glucose level, he dials a toll-free number, enters his personal code, and follows the computer prompts to enter the...

Physicians appreciate DM assistance; company works hard to build good relationship.(disease management)
March 1, 2003... Christobel E. Selecky actually has had physicians thank her for sending them treatment guidelines along with information about their patients with chronic diseases. "Instead of assuming we're telling them what to do, they feel like it's a...

Program targets diabetics with highest utilization; frequent interventions for sickest members.
March 1, 2003... When it comes to a common disease such as diabetes, "we can't manage the universe," Giavanna Ernandes, RN, MSN, APNC, asserts. "My philosophy is that, although you can't reach out to everybody, you can make a difference for the sickest...

Little things indicate a patient has depression; diagnosis is common in the chronically ill.
March 1, 2003... A patient whose chronic illness you are managing is not likely to tell you that he or she is depressed. Instead, you may hear little comments here and there that indicate something is going on with the patient besides just the physical...

CE questions.
March 1, 2003... For more information about the CE program, please contact customer service at (800) 688-2421. E-mail: customerservice@ahcpub.com. 9. Reinsurance is designed to cover illnesses and injuries that cannot be predicted because of low frequency....

Plan knowledge affects how consumers look at cost of drugs.(Brief Article)
March 1, 2003... Consumers' drug-buying behavior may be based on how much they know about their personal health care coverage, a Harris Interactive survey reveals. According to the survey, consumers with low levels of knowledge about their coverage appear...

Musculoskeletal conditions, mental health impact productivity.(Brief Article)
March 1, 2003... Musculoskeletal conditions, including arthritis low-back pain, repetitive motion strain, and mental health problems--mostly depression--have the biggest negative impact on worker productivity, according to a survey by the Institute for Health...

Physicians report frustration with managed care red tape.(Brief Article)
March 1, 2003... Sixty percent of physicians responding to a survey by the Pennsylvania Medical Society expressed frustration with eroding patient-doctor relationships and blame lack of time for the problem. The survey of 330 physicians revealed that they...

White paper addresses HIPAA concerns and DM.(disease management)(Brief Article)
March 1, 2003... A comprehensive analysis of the Health Insurance Portability and Accountability Act (HIPAA) and its impact on disease management has concluded that the new privacy regulations will not hamper disease management programs, according to the...

Order your smallpox vaccination handbook today.(Brief Article)
March 1, 2003... Call today for your copy of Hospital Handbook on Smallpox Vaccination, a facilitywide resource containing all the information you need about smallpox vaccination in most health care facilities and environments. Learn about possible side effects...