Archives for February 2019

Care Management Training is Key to Effectively Addressing Diverse Needs

One could argue that health plans use case managers in much the way a financial advisor manages a client’s portfolio. By evaluating the client’s needs and determining how to provide care efficiently using the resources at hand, care managers are able to keep costs down and ensure clients get the best care possible.

On the surface, it is easy to think the job description for a case manager is simple and straightforward, but the role has many moving parts, requiring a skill set that ranges from expert communicator, to adept multi-tasker, to team player and coach.

Case Managers Play Multi-Faceted Role

Care managers wear many different hats and function in a multi-faceted role that grows in complexity with challenging client cases. Health plan case managers are mediators, educators, negotiators, moderators, and experts. From day-to-day, the case manager must work with clients, providers, and payers, each with a distinct view of what constitutes appropriate care.
[Read more…]

New Tools Make Communication Easier, but Case Management Outreach Still Key

For case managers, the key to helping patients adhere to their treatment plans is to make the process easy. According to the World Health Organization (WHO), a lack of doctor-patient communication is one of the biggest reasons patients are not compliant with their healthcare plan. Lack of compliance places a financial burden on society, ultimately increasing case management workload and healthcare costs.

One clinical study found that focusing on education and follow up with patients resulted in better compliance, and therefore better outcomes. Those who received careful education and were engaged with providers and case managers demonstrated a better understanding of their diagnosis and the recommended treatment.

How can case managers make engagement easier for the clients and patient they serve? One approach is by utilizing technology that’s already a part of their daily lives.

[Read more…]

Case Managers Improve Communication Among Patients, Providers, Pharmacists

Nearly 133 million Americans—more than 40 percent of the total population—are affected by chronic and generally incurable diseases. This number is projected to grow to an estimated 157 million, including 81 million with multiple conditions, by 2020.

Not surprisingly, more than 75 percent of all healthcare costs are related to chronic health conditions, such as diabetes, heart disease, hypertension or mental illness. The treatment of these and other chronic illnesses commonly includes long-term medications.

Yet the full benefits of many medications may not be realized because an estimated 50 percent of patients do not take them as prescribed. A key role of care managers is engaging patients to consistently take their prescribed medications.

[Read more…]

Care Managers Use Knowledge, Empathy to Assist Clients Struggling with Addiction

Case managers are on the front lines of an opioid epidemic that is responsible for indiscriminately taking lives and destroying families. Every day more than 130 people in the U.S. die from an opioid overdose resulting from the misuse and addiction to prescription pain relievers, heroin, and synthetic opioids such as Fentanyl. This epidemic is a serious national crisis affecting public health, and social and economic welfare.

The Centers for Disease Control and Prevention (CDC) estimate opioid misuse in the U.S. creates an economic burden of $78.5 billion a year. The statistics are staggering:

• Nearly 29% of those prescribed opioids will misuse them
• Up to 12% develop an opioid use disorder and an estimated 6% who misuse prescription opioids will transition to heroin
• Opioid overdoses rose by 30% in the year between July 2016 and September 2017 in over 45 States, while the Midwest experienced overdose increases of 70%

[Read more…]