There are 7 item(s) tagged with the keyword "Care Management".
Displaying: 1 - 7 of 7
- Understanding and Encouraging Hospice Benefits
Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health.
This is an important topic our clients are seeking information on, so we wanted to share more details here. Health systems can save money and human misery when they better understand end-of life care options.
Palliative care and hospice are different. The National Institutes of Health (NIH) – National Institute on Aging (NIA) shares some valuable clarification and information. While both include a multidisciplinary approach to relieving symptoms and providing comfort, palliative care may also include curative treatment, whereas hospice does not. Palliative care can be a good segue to hospice. To qualify for hospice care, providers must believe that, assuming a normal course of illness, an individual has six months or less to live. However, estimating remaining life is difficult, and improvements in care through hospice may extend life, while definitely enhancing access to necessary healthcare and comfort measures.
- Pre-Emptive and Analytics-Based Early Action Can Delay Kidney Dialysis, Reduce Plan Costs and Improve Quality of Life
Barbara Rutkowski, EdD, MSN, CCM - Vice President, Clinical Operations, Advanced Plan for Health & Joy McGee-Cory - Senior Vice President, Advanced Plan for Health
Early intervention is the key to slowing or stopping chronic kidney disease (CKD), improving the quality of lives for those at risk and containing health plan costs. Avoiding dialysis for just one member represents a health plan savings of $350,000 to $700,00 per year, which more than pays for the CKD program by itself.
- Combating Opioid Addiction with Analytics and Case Management
The current opioid epidemic has shed light on the shortcomings of many wellness programs and the lack of preparedness by case management teams to handle chronic conditions and or patient behavior, such as addictive tendencies or duplicate therapy. But are case management teams solely to blame for lack of effective response to this costly health crisis? The simple answer is, no.
Many case managers do not have access to the data or tools required to employ a compelling and value-driven prevention model. Hence, what we see today is very little accountability or effective case management. What’s needed most is quality data to guide active engagement with patients.
- Nurse Care Navigators' Value to the Self-Insured Health Plan
To nurse care navigators, care management is exactly that – managing people with care.
Mentoring clinicians and health plan professionals in learning how to guide and support people, wherever they are on the healthcare continuum, is my opportunity to pass on the secrets of population health management that so many wonderful professionals have shared with me.
Making a difference in people's health, while optimizing resources so that people and health plans get the desired results, is my idea of success.
- Chris Galanos - Director, Medical Services
Chris Galanos was Vice President Customer Solutions–Care Management for UMR, the third-party administrator (TPA) unit of UnitedHealthcare. He was responsible for the UMR portfolio of care management services.
- Poindexter Predictive Modeling Engine
Poindexter, our data analytics risk engine custom-built for population health management. This tool provides dynamic, reliable insight into your population. With Poindexter you have access to essential insights in just a few simple clicks, whether you are at the strategic, provider or clinical user level. With Poindexter, you have the guidance to work smarter and stay focused without losing the “big picture” perspective. Macro trends can be detailed and compared over time with the ability to drill to specific drivers in minutes—all at your fingertips; no need to wait for answers you need today to stay on track.
Poindexter enables revolutionary predictive modeling by looking at the whole individual, as well as group trends, by examining hard data in a practical format and factoring in the impact of rapid changes in healthcare. The result is the ability to predict conditions, trends, gaps in care, admissions and re-admissions- six to 12 months in advance. This analysis of individuals within a population ultimately identifies opportunities and risks; key information in the creation of APH's customized action plans.
- Company Overview
We are specialists focused on successfully managing risk and optimizing health care benefits and costs; no matter the model of care or type of entity taking on financial risk. We've been in the advanced and predictive healthcare analytics space for years, which has allowed us to continually advance our solutions and refine our action plans so our clients gain unrivaled ROI.
Displaying: 1 - 7 of 7