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Welcome to the case management learning portal, where it is our business to keep you informed. In this section you will find the latest headlines, trends and studies that bear importance on the practice and the industry. In addition, you will find a fleet of articles intended to keep you current on the issues and outcomes that impact your practice on a daily, weekly and monthly basis. Industry experts and seasoned professionals contribute their acute insight on professional and clinical topics alike. Visit with our experts now and secure the strength of your work in the future.



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Health Care Costs Increase at Double Digit Rates: Buck Consultants Survey

NEW YORK: Jan. 28, 2010 – Costs for the most popular types of health care coverage are projected to increase at double-digit rates for 2010, according to a national survey of insurers and administrators by Buck Consultants, an ACS company. 
 
In its 21st National Health Care Trend survey, Buck Consultants measured the projected average annual increase in employer-provided health care benefit costs. The study analyzed responses from over 100 health insurers and HMOs. Insurers providing medical trends for the survey cover a total of approximately 78 million people.
 
Costs for the most popular medical plans are projected to increase by more than 10 percent and are in line with the trends reported in the prior two surveys, as shown in the following chart:

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This Is an Emergency

Catastrophic | Friday, 2 October 2009

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Scoping the Challenges of Trauma Case Managers   Hospital case management is a demanding field, where challenges spring up in a moment’s notice. Crystallizing these challenges is the level one trauma center, which places case managers in what are often formidable positions. Walk a shift through the eyes of a trauma case manager and here’s what you’re likely to face (in the Southwest meltinig pot where I work, at least): establishing the identification of a deceased trauma victim and engaging local police in an effort to assist; notifying family or friends of a victim that just arrived; crowd-control and grief resources for 30 Native American family members presenting en masse following their loved one’s death; an illegal foreign national patient without any funding for services post-discharge, the discharge plan requiring medication; patients requiring durable medical equipment and rehabilitation; out-of-state visitors triaged to the center requiring transportation home, which is six hours away; respecting and adhering to religious beliefs of the exsanguinating Jehovah Witnesses patient refusing blood products; discussing organ donation of a teenager; homicides; suicides; psychiatric crises; and the always varying ages and socioeconomic situations of infants, teens, elderly, professionals, homeless, high-profile celebrities, and the “John Doe” unidentified ...

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Stories of Cancer Survivorship

Disease Management | Monday, 28 December 2009

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Glimpses of Hope Dear Readers,   To complement our cover story in  the December 2009 issue of Case In Point—A League of Survivors: Cancer Care Update 2010—we present an inspiring, online-exclusive series on cancer survivors who have written about their own experiences in facing a diagnosis, preparing for their journey and attempting to come to grips with survivorship. In reading each story, it becomes apparent that surviving cancer is all about attitude. You must commit to the fight, and you will almost inevitably need a team to help you when your willpower starts to fail.   We all know—or will know—someone who has cancer. If you find this series of stories insightful and helpful, please feel free to share the website with those who you think may benefit. Here are the sad, heartfelt and ultimately rousing stories of individuals facing the test of a lifetime: Confronting Cancer with Humor, Hope By Karen Meyer ...

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Standing Up to the Bully

Behavioral Health | Friday, 2 October 2009

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Repudiating the abuse of a harmful, yet prevalent, act Bullying, a word that may conjure up the image of a belligerent provocateur kicking sand in the face of an awkward 90-pound adolescent, has long been as misunderstood as it is prevalent in human experience. In recent years, with evidence mounting behind the tenet that bullying was a contributing factor in a multitude of the challenges facing educators in the classroom, researchers began to take a closer look at the causes and consequences of what was once deemed merely “kids being kids.” What they found was not only shocking but proved that bullying is more than simply a school problem; it is a societal issue that impacts the physical and emotional well-being of millions of human beings of all ages. It can be found in preschools and nursing homes, in occupations and daily activities, and everywhere in between. It takes a toll on the productivity of the workplace, the quality of care given in hospitals, and the physical and emotional well-being of our families and friends. A culture that promotes bullying carries not only an inestimable human cost, but, it turns out, a whopping financial price tag as well. Dashing Myths, Promoting Peace Contrary to ...

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Maximum Engagement

Workers' Compensation | Wednesday, 16 December 2009

Creating a Successful Return to Work When an employee is off work due to an illness or injury, the ideal goal from a vocational standpoint is for that person to return to work, an objective that must be embraced by all involved parties, including the employee, employer, case manager, physician and other care providers. A return-to-work outcome is also at the heart of motivating the worker who is ill or injured or has a disability. When handling a workers’ compensation case, particularly when the injury, illness or disability is severe, motivating employees can be challenging. The key is to help workers see that a return is possible, even in spite of a life-altering condition. Successful return to work has a far better chance of occurring when the employee is engaged in the process. This must begin as soon as possible—and long before maximum medical improvement is achieved. As research has shown, the longer a person is off work, the less likely he will go back to the workplace. A strong link with the workplace must be preserved. Not only does the employee feel valued by the employer and colleagues, but the individual is far more likely to see that her contribution is missed. In ...

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Ask the Expert: Case Management and Soci

Advice | Tuesday, 15 December 2009

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To explore recent and potential changes to the practice, we consulted with Garry Carneal, JD, MA, the president and CEO of Schooner Healthcare Services, LLC, to talk about the impact of social networking and wireless communication on case management. Garry is also co-chair of the steering committee at the Population Health Impact Institute.   Case In Point: How are advances in technology changing the landscape of case management and what technology specifically is leading the way?   Garry Carneal: According to several reputable resources, more than 2.5 billion text messages will be sent today in the United States. Texting has now become the most prolific form of mobile communication in the United States, overtaking cell phone calls. Howard Rosen, the founder and CEO of Life:WIRE, which is an interactive health management solution that uses text messaging and email, recently noted that “text messaging is taking off not only for younger Americans, but over half of all Americans who send and receive text messages today are 35 years and older.” This is a unique development. And now dozens of text messaging platforms for health care are being offered in the market, running on everything from smart phones to basic cell phones, to improve communication channels, increase efficiencies and ...

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Q and A: Pamela Doty and Consumer Direct

Profession | Tuesday, 26 January 2010

To better understand the intricacies of the consumer direction movement, Richard Scott sits down with Pamela Doty from the Department of Health and Human Services who authored the study New Strategies to Meet Long-Term Care Needs that appeared in an early January issue of Health Affairs.   Can you describe consumer-directed long-term care service programs? These are service delivery models designed to empower people with chronic disabilities and their families. They gain considerably more choice and control over the who, what, where, when of their home and community-based long-term services and supports than they would have in a more traditional “provider-driven” system. What do these programs hope to achieve? The goal is a more flexible service system that is able to be responsive to what service users and families want. We have observed that different constituencies tend to be drawn to consumer direction for somewhat different reasons. For example, among older people, the main motivation is typically that they want to have home care workers whom they know and trust, individuals who know them and their preferences and that they feel comfortable with. This often means that older people choose consumer direction because this allows them to hire family, friends, and neighbors as their paid caregivers ...

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  • Marcia Colone on Advancing Care, Escalation

    Richard Scott In this inaugural edition of The CM Insider section of Case In Point Weekly—a section that will bring readers face to face with

  • The Constant Rebalancing of Lee Woodruff

    Confronting the Demands of Life in the Face of Traumatic Events The news shattered the quiet veneer of the morning. In a hotel room on the oneiric

  • Update on Bloodborne Diseases

    Exploring Hepatitis B and C and HIV The research-based facts for bloodborne diseases are constantly changing, requiring case managers of all popula

  • No Innocent Bystanders

    A Critical Building Block for Successful Good-Conduct Policies This past January, the Joint Commission’s new standards addressing behaviors t

  • Uplifting an Aging Workforce

    Addressing the Physical, Psychological and Psychosocial Needs of Older Workers When an employee becomes injured on the job, it is essential to cons

  • Ask the Expert: Quantifying Caseloads

    We pose a series of questions to Kathy Craig, MS, RN, CCM, president of Craig Research Continuum, to learn about the growing set of tools surrounding

  • Integrated Case Management

    Merging Physical and Behavioral Health It’s no secret that the future of health care delivery is somewhat uncertain. While few will disagree

  • A Fix on Frequent Flyers

    How an ED Countered Overuse Three years ago Dr. Salvatore Vertaramo came up with an idea. As with most emergency departments, we had developed

  • Taking a Second Look

    Two Patients with Spinal Cord Injury Undergo Continuing Care at the Rehabilitation Institute of Chicago Visiting a friend one day in 1993, Charl

  • Home Care Guardians

    The specialized services of Visiting Angels Today, more than 7.5 million Americans receive home care services. In light of demographic and political t

  • Monitoring Rare Disease, Remotely

    With rising health care costs and greater longevity of people living with chronic diseases, case managers must provide services that are cost-effectiv

  • Grappling with a Hard Case

    Assessment and Case Management of the Substance Abuse Patient The assessment and treatment of addictions is a challenging area for both clinicians an

  • Pain: Do Your Patients Have It?

    On March 30, 2009, the House of Representatives passed the National Pain Care Policy Act, a piece of legislation designed to improve, as it is written

  • Ask the Expert: Illness and Return to Work

    In this edition of Ask the Expert, we consult with Rosalind Joffe, the founder and president of cicoach.com, a career coaching firm dedicated to helpi

  • Coaching as Coaxing

    Ask the right questions, listen carefully, and empower clients to choose Last issue, I cited 10-time NBA championship coach Phil Jackson to illustr

  • New Dimensions in Disease Management

    Best Practices in Telemanagement The cost of managing chronic illness has become astronomical. Congestive heart failure is now a major chronic cond

  • Trials of Redemption

    Kasey Edwards Combats the Loss of Limb It was well past midnight when Kasey Edwards dove into the canal. A native of the region surrounding Lake O

  • Young at Heart

    Recognizing the Elderly Marks a Boon For Appropriate Care Though Taber’s Cyclopedic Medical Dictionary describes an “elder” as a

  • The Uncertain Unraveling of ALS

    The rollercoaster began in 2003. It was in the summer of that year when my dad first exhibited symptoms that were later diagnosed as manifestations of

  • Handling Hardship

    Dealing with Loss in Lay and Professional Roles Everyone loses a loved one at some time or another. As practicing psychologists for many years,

  • Pain Sage

    A pain expert discusses the varieties, the management and the modern medical advances in the thorny field of pain   Dr. William Witt, a profess

  • Ask the Expert: Coding

    In this edition of Ask the Expert, Teri Treiger, RN-C, MA, CCM, CCP, CPUR, a Clinical Product Manager at McKesson Health Solutions and forthcoming Pre

  • Downsizing, Right-sizing, Re-engineering, Restruct

    Managing Before, During and After the Crisis In Part I of this series, the discussion centered on workplace restructuring and how that affects the ma

  • Community Care at Shepherd’s Hope

    The ongoing series called A Passion for Practice continues with a look at a community clinic in Arkansas An unfortunate circumstance is all too commo

  • Exploring Long-Term Care

    The scope of enduring care, the benefits of long-term acute care hospitals, and what the shift in demographics means to the viability of the industry

  • A League of Survivors: Cancer Care Update 2010

    Once seen as the equivalent of a death sentence, today a diagnosis of cancer more likely means dealing with a chronic disease with exacerbations and r

  • The Aging Family

    Behavioral Health Across the Continuum of the Over-50 Divide Few care managers have studied the continuum of care across the aging family. Gerontol

  • The Forest for the Trees

    How To Identify the Variables of Chronic Pain To Achieve Holistic Return to Work   Researchers estimate that there are currently at least 75 mi

  • Ask the Expert: Accreditation

    In this edition of Ask the Expert, a reader proposes a question about accreditation standards. We consulted with expert Cynthia Whitaker, a clinical a

  • Crossing the Management Chasm

    Developing Leaders from Technicians Why is it that some people thrive when promoted through managerial ranks, while others no less intelligent and

  • An Effective Case Model

    Case management and behavioral health In 2007 the HIP Health Plan of New York restructured its case management program for clients at highest risk of

  • Guiding Hands

    Ethical and Cultural Considerations During the Final DaysComprehensive case management continuously addresses the complexities of illness and the prom

  • Fending Off Hepatitis

    Guidelines Target Viral Hepatitis in the Hospital A global public awareness campaign from the World Health Organization poses what appears as a sim

  • PTSD: Trauma That Does Not Abate

    Coming to Grips with Post-Traumatic Stress Disorder A nurse manager was shot leaving work by an employee who she recently terminated for repeated abs

  • Straining the System

    WORK-RELATED INJURIES ARE PUTTING A STRAIN ON THE WORKERS’ COMPENSATION SYSTEM. LEARN ABOUT THE PREVENTION AND TREATMENT OF COMMON I

  • Ask the Expert: Wellness

    In this edition of Ask the Expert, we pose questions to wellness guru Margaret Moore to understand the increasingly popular trend of wellness coaching

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