Case
Management
Consumer, payers, providers,
employers, regulators and society are demanding a method to determine value,
quality, accountability, and cost efficiency in the provision of health care
services across multiple continuums of care, health and life. To meet these
demands, organizations must set up effective strategies. Case management is
recognized as one of the most effective strategies. As organizations move
to implement case management, it is apparent that they must choose models
that are aligned with the needs of the environment.
A case management model
for capitation and managed care requires a specific infrastructure that delineates
the process by which the clients, the case managers and the systems interact
to achieve planned outcomes. In a managed care and capitation environment,
the basic goal of any case management model is to provide for quality, accountability,
effectiveness and efficiency. Case management models must be:
HCRG is an approved continuing
education provider. We have designed and presented outcome based case management
education throughout the U.S. to payer, provider, regulatory and consumer
organizations
Our case management education
programs are based on outcomes and performance management. They are specifically
geared towards managed care and capitation and can be customized to meet our
clients needs.
Partial list of current
case management educational programs:
- Advanced Case Management,
2 Day Program
- Case Management -
A Certificate Course, 3 Day Program
- Emergency Department/Community
Case Management, 1 Day Program
- Neonatal Intensive
Care: Case Management, 1 Day Program
- Outcome Management,
1 Day Program
- Case Management: Mental
Health, 1 Day Program
- Outcomes Based Workers
Compensation Case Management, 1 Day Program
- Medicare, Medicaid
Case Management, 1 Day Program
Educational
Programs
Our case management educational
programs can be tailored to meet your requirements and can be presented at
your facility. Major components include:
- Business cost/economics
of healthcare
- Case Management for
the 21st Century
- Roles and tasks of
case management in different settings
- Case management practice
framework, tools outcome based critical pathways
- Legal aspect of case
management practice
- Emergencies in case
management
- Case management for
the continuum of care, life and health
- Advanced case management
concepts
- Changes required to
meet the structural, technical and measurement needs for CM implementation
- Financial management
- Conflict resolution
and negotiation
- Advanced use of critical
pathway
- Outcome management
and statistics
- Case management strategic
planning
- Definition of outcome-management
- How are outcomes planned?
Outlining areas of strategic essence to obtain outcomes
- Outcomes measurement,
establishing units of measure
- Implementing the outcome
measurement process along the continuum
- Outcome management
vs. traditional case management
- Management of information
- Turning data into information
- Concurrent variance
management vs. retrospective variance management
- Inferential statistics
in outcome management
- Integration of outcome
management with accreditation requirements JCAHO/NCQA
- Model for implementing
outcome management
- CM model for the NICU.
Development of multidisciplinary plan of care for the NICU
- Developing and implementing
critical pathway for the NICU
- Design of ED CM model
to meet the needs of the payer, the provider and the consumer
- The ED infrastructure
for case management
- Application of CM for
chronic pain, mental health, drug we, homeless, complex medical frail elderly
- Use of case management
tools
- ED outcome measurement
and much more
- Design of mental health
case management model
- Outcomes based workman's
compensation case management model
