Case Management
Effective and Efficient Case Management
Case Management is essential for ensuring a seamless continuum of care. For over 15 years, Advis has championed centralized case management, adapting to significant regulatory changes and the evolving landscape of healthcare reform. Today, with a focus on value-based care, utilization scrutiny, and payment for care episodes, effective case management is more critical than ever.
The Case Management Team
The case management consulting team includes many more individuals than simply those with the title of “Case Manager”. The team must consist of all key clinical personnel including the nurse, the physician and the case management team, each of whom has specific roles. Administration also plays a role in assuring each member of the team is on board with the hospital or health system’s goal to assure that the patient is at the right place at the right time in their episode of care.
Elements of Case Management
The key elements of our case management projects include:
- Situational Audits: Identify the status of existing care options.
- Interim Leadership: Provide temporary case management leadership as needed.
- Infrastructure Enhancement: Identify opportunities to improve the continuum of care infrastructure.
- Data Evaluation: Analyze discharge data and in-house patients to find areas for improvement through education and process revision.
- Process Improvement: Implement or revise processes for more efficient and meaningful data collection and use.
- Financial Profiling: Develop a hospital profile to identify financial vulnerabilities and optimize care utilization to minimize financial burdens.
- Scope Determination: Establish the scope of case management based on disease/venue management and payor mix for capitated/risk patients.
- Staff Engagement: Conduct interviews and informal orientation sessions with medical staff to address concerns, gather suggestions, and ensure accurate information dissemination.
Case Management Education
Reimbursement penalties for readmissions have made case management more critical than ever. Our projects include evaluating and educating staff on readmissions that impact the hospital and preparing for future changes in diagnosis-related reimbursements. Advis offers comprehensive training tailored to each institution or system.
Get Started with Advis
Ensure your healthcare facility’s case management is effective and efficient. Contact Advis today to learn more about our services and how we can support your team in delivering top-quality care.
