Ca. Case Management
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HCT Consulting provides case management consulting services to help hospitals reduce length of stay, increase payor authorization rates, and improve clinical outcomes by transforming their case management approach from a utilization review model to one focused on care facilitation, payor compliance, and proactive management of patient care. Their services include analyzing length of stay and financial performance data, improving documentation practices, and engaging physicians and staff in collaborative care processes. A case example showed that one hospital achieved a reduction in Medicare length of stay after working with HCT to implement changes to its case management program.
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in order to meet cost reduction targets, CMOs
* Share patient data across ecosystems
* Embed shared organizational intelligence
* Establish guidance for quality & cost within physician workflows
* Prepare physician leaders to create a culture of continual improvement
Ania 2013 poster zanett_final_2 people_process_technology
This document discusses clinical transformation utilizing nursing informatics. It states that extracting measurable data values can improve healthcare quality, enhance services, and reduce costs. Clinical transformation brings an interdisciplinary approach to redesigning care delivery across the entire care continuum to achieve excellence and meet regulations. The document emphasizes that successful clinical transformation requires involvement from people across all professional disciplines, deployment of flexible technology systems, and a clear understanding of current and future states when redesigning processes.
How Decision-Support Tools Cure the Prior Authorization Time Drain
A collaboration between Cognizant, the New England Healthcare Exchange Network and Informatics In Context is demonstrating how a real-time prior authorization (PA) system for medical and administrative processes saves time and money.
Anne Bracken Univ of South AL - aco rural health
1) Accountable Care Organizations (ACOs) are groups of doctors, hospitals, and other care providers who come together voluntarily to give coordinated high quality care to their patients.
2) ACOs aim to improve care and lower costs through improved care coordination and preventative care. They are paid for keeping their patients healthy instead of paying for each test and procedure.
3) For ACOs to be successful, providers need organizational capabilities like managing risk, using electronic health records, tracking performance measures, and engaging patients in self-care.
HealthCare Relationship Services Challenge & Solution Portfolio - 215
HRS provides healthcare executive relationship services and solution assessments focused on improving the patient experience and addressing challenges caused by ACA mandates. There are several challenges impacting the patient-provider relationship, including patient experience metrics that impact reimbursement, an increasing number of uninsured patients, constraints on caregiver capacity, becoming a data-driven organization, delivering integrated care throughout the patient lifecycle, accurate ordering and revenue cycle management, quickly implementing ACA requirements, transitioning to a value-based and patient-centric model with price transparency, and accelerating accurate claims cycles. HRS' solutions aim to address these challenges through approaches like accelerated learning, virtual offices, data analytics platforms, communication and workflow solutions, performance management, and improving order accuracy
Prior Authorization Outsourcing_ Streamlining Healthcare Approvals.pptx
Efficiently streamline healthcare approvals through our Prior Authorization Outsourcing services. Contact 24/7 Medical Billing Services Now.
Final FAB Executive Summary - 2016
The healthcare industry is facing challenges around patient satisfaction, turnover, and readmissions. The discharge process directly impacts staff, patients, revenues, and facility rankings. Research shows patient satisfaction can decline by 70% during the discharge process due to breakdowns. Fill A Bed allows hospitals to directly communicate and identify the most appropriate step-down facilities to place patients based on their care needs, reducing costly readmissions. The digital solution brings efficiency and continuity of care to the outdated discharge process. Fill A Bed was developed by healthcare professionals to expedite discharges through centralized tracking and increased communication between facilities.
Prior Authorization Outsourcing_ Streamlining Healthcare Approvals.pdf
Efficiently streamline healthcare approvals through our Prior Authorization Outsourcing services. Contact 24/7 Medical Billing Services Now.
Virtual Health & Telemedicine
Virtual health is supporting continuing efforts to further humanize health care by extending and expanding the concept of a patient-centric care delivery model into one that is truly life-centric.
Virtual health uses telecommunication and networked technologies to connect clinicians with patients (and with other clinicians) to remotely deliver health care services and support well-being. For providers, committing to virtual health at a personal and organizational level affords ever-increasing opportunities to deliver the right care at the right time in the right place, in a connected and coordinated manner.
By strengthening and facilitating a therapeutic alliance between clinicians and patients, virtual health is an important step on our continuous journey to humanize health care. It works within and around a patient’s life, as opposed to their sickness, to deliver care when, where, and how they need and want it. Also, virtual health works its way into consumers’ daily routines by being embedded in electronic devices associated with living life (e.g., smartphones and personal computers) more so than caring for sickness.
The healthcare industry is primed for expanded adoption of virtual health; a 2016 report estimated that the US virtual health market will reach $3.5 billion in revenues by 2022. Several factors are elevating stakeholder interest, including expected physician shortages, continued growth in digital technologies, changing reimbursement models, increasing consumer demand, and the evolving regulatory landscape. One game-changer: Today, nine in 10 American adults use the internet, giving clinicians the capability and flexibility to communicate with and serve health care consumers via the web.
Hospital readmission reduction's impact on assisted living feb 2013
This document discusses how hospital readmission reduction programs under the Affordable Care Act are impacting assisted living facilities. Hospitals now face penalties for excessive readmissions within 30 days of discharge, prompting them to form Accountable Care Organizations and shift patients to lower-cost post-acute care settings like assisted living. As hospitals feel the financial pressures, assisted living facilities need to demonstrate their ability to provide quality care and minimize readmissions in order to maintain partnerships with hospitals and referral sources. The document provides strategies for assisted living facilities to enhance their services, collect data, and implement best practices to adapt to these healthcare industry changes.
Six Sigma Improves Healthcare Operations
Six Sigma is a structured process for defining, measuring, and controlling opportunities for improvement in repetitive processes. It can significantly reduce defects in healthcare by focusing on operational efficiency and translating patient needs into defined tasks. While Six Sigma is misunderstood in some healthcare organizations, it does not sacrifice clinical quality or cut costs at the expense of patients. Key elements for successful Six Sigma implementation include focusing on patient requirements, designing processes to meet them, measuring performance, involving staff, and using a systematic problem-solving approach with senior management support. Healthcare systems often look outside for experts to initially launch Six Sigma programs and improve integration of new technologies.
Similar to Ca. Case Management (20)
Healthcare by Any Other Name - Centricity Business Whitepaper
Healthcare by Any Other Name - Centricity Business Whitepaper
The Community Health Center Challenge: Like No Other
The Community Health Center Challenge: Like No Other
Integrating Clinical Documentation Improvement and Utilization Management.pdf
Integrating Clinical Documentation Improvement and Utilization Management.pdf
Mass HIway Enrollment and Onboarding - May 8, 2014
Mass HIway Enrollment and Onboarding - May 8, 2014
Revenue Cycle Management Challenges Facing Healthcare Providers Today.pdf
Revenue Cycle Management Challenges Facing Healthcare Providers Today.pdf
Optimizing Healthcare_ A Comprehensive Guide to Health Insurance Verification...
Optimizing Healthcare_ A Comprehensive Guide to Health Insurance Verification...
Ania 2013 poster zanett_final_2 people_process_technology
Ania 2013 poster zanett_final_2 people_process_technology
How Decision-Support Tools Cure the Prior Authorization Time Drain
How Decision-Support Tools Cure the Prior Authorization Time Drain
HealthCare Relationship Services Challenge & Solution Portfolio - 215
HealthCare Relationship Services Challenge & Solution Portfolio - 215
Prior Authorization Outsourcing_ Streamlining Healthcare Approvals.pptx
Prior Authorization Outsourcing_ Streamlining Healthcare Approvals.pptx
Prior Authorization Outsourcing_ Streamlining Healthcare Approvals.pdf
Prior Authorization Outsourcing_ Streamlining Healthcare Approvals.pdf
Hospital readmission reduction's impact on assisted living feb 2013
Hospital readmission reduction's impact on assisted living feb 2013
Ca. Case Management
- 1. Case Management, California T- 312 214-7216 info@hctconsulting.net www.hctconsulting.net
- 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. 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. HealthCare Transformation, LLC 70 West Madison Street Three First National Plaza Suite 1400 Chicago, IL 60602 T- 312 214-7216 F- 312 214-3110 www.hctconsulting.net