Case Management Advisor articles from March 2004

Case Management Advisor archives from March 2004

Medical directors are a great source of support for case management: teamwork helped to optimize patient care.
March 1, 2004... If you're not calling on the resources of your company's physician medical directors, you may not be maximizing your resources to optimize patient care. "Physicians who have oversight of case management programs can play an important role...

CMs coordinate care for at-risk members: CM and UM departments are separate.
March 1, 2004... A program in which case managers coordinate the care of members with complex medical , conditions and those who are at high risk for chronic diseases has paid off for Care Choices HMO of Farmington Hills, MI. Separate departments ...

Depression program boosts HEDIS scores; members stay on their medication longer.
March 1, 2004... A depression management program has resulted in better scores on Health Plan Employer Data Information Set (HEDIS) measures and a reduction in depression screening scores for Fallon Community Health Plan, with headquarters in Worcester, MA. ...

3-pronged approach to DM wins award for health plan; DM, CM, concurrent review work together.
March 1, 2004... Great-West Healthcare's disease management approach won the Denver-based company the award of best disease management program in a national PPO for 2002-2003 from the Disease Management Association of America (DMAA). "The DMAA award...

Couple predictive modeling with DM: system includes clinical alerts, diagnosis risk groups.
March 1, 2004... A predictive modeling program is just the first step in identifying members for a comprehensive disease management program, says Michael Cousins, PhD, manager of health informatics for Health Management Corp. (HMC), based in Richmond, VA. ...

When providers come bearing gifts, should case managers accept? Take care to avoid appearance of ethical problems.
March 1, 2004... When it comes to accepting cash payments from providers in exchange for referrals, there is no question: It is expressly forbidden. But what happens with noncash items, such as the seemingly innocuous gifts that show up around the holidays or...

CE questions.
March 1, 2004... 11. According to Sam Toney, MD, and Cheri Lattimer, RN, of Health Integrated Inc., medical directors can support case managers in what ways: A. Pharmacy monitoring and experimental treatments B. Intervening with primary care physicians...