Ca. Case Management


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Ca. Case Management

  1. 1. Case Management, California T- 312 214-7216
  2. 2. TRANSFORMING YOUR CASE MANAGEMENT’S Length of stay Claims management Clinical outcomes Successful case management requires collaboration among case managers, social workers, nurses, and many others in a position to impact the timeliness and appropriateness of care delivered to patients. By helping your hospital look at the interrelationship of all actions that impact a patient’s progression along the acute-care continuum, HCT can help you create a more proactive approach to managing the process. We can help you: • Reduce lengths of stay, where appropriate • Increase the rate of payor authorization and reimbursement • Improve patient care outcomes
  3. 3. Length of stay: HCT helps you transition your case management model from utilization review and discharge planning to care facilitation. Often this involves improving communication among staff, making changes to work flow or work assignments, and utilizing better patient tracking systems. It means working not only with staff, but engaging physicians in the process of providing timely patient care, documentation, and discharge. Payor compliance: HCT performs an in-depth analysis of financial performance relative to payor requirements, including Medi-Cal and Treatment Authorization Records (TARs). One of the hallmarks of the HCT case management program is its approach to Medi-Cal and denials management. Combining techniques to improve physicians’ and case managers’ documentation, with a proactive, aggressive approach to case management, has allowed HCT to effect a reduction in denials by as much as 15%. Clinical outcomes: Taking a more proactive approach to case management can create better clinical outcomes for patients and prevent “never events.” During the process of reducing length of stay, improving collaboration among staff, and examining appropriateness and timeliness of care, we help you increase your performance in meeting evidence-based quality, safety, and care goals. Measurable results: e graph below provides an example of the success made in reducing Medicare LOS in a 220-bed facility. ALOS 220-Bed Facility 6.0 Implementation 5.0 4.0 3.0 2.0 Q1 Q2 Q3 Q4 2005 2006
  4. 4. HealthCare Transformation, LLC 70 West Madison Street Three First National Plaza Suite 1400 Chicago, IL 60602 T- 312 214-7216 F- 312 214-3110