You’ve likely heard of social determinants of health. But healthcare systems and policymakers have coined a number of other terms for similar concepts. This mishmash of terminology is a potential threat to making progress on these issues.
Jody, a case manager, is managing a complex case that tests every bit of her many years of experience. The patient is Henry, a 70-year-old recovering from a moderately severe stroke.
Palliative care is a phrase that may strike fear and confusion in patients and their family members because it’s commonly associated with hospice. But the true definition of palliative care is specialized support and treatment for people living with a serious illness.
A panel of experts recently tackled some common billing questions in a Q&A session at the Mastering Utilization Review and Patient Status: A NAHRI Virtual Event conference. Here are some of their responses.
Tiffany Ferguson, LMSW, ACM, and Marie Stinebuck, MBA, MSN, ACM, CEO and COO at Phoenix Medical Management Inc., discuss why the best strategy to prevent denials related to medical necessity is a proactive approach that focuses on front-end processes.
A former nurse is now facing prison time after being convicted of negligent homicide and impaired adult abuse for a medical error that led to a patient’s death.
In 2023, the next step in healthcare reform is projected to emerge with the ACO REACH Model’s introduction. This ACO version builds on previous achievements, in conjunction with a progression and enhancement of earlier efforts.
Rose's neighbor Mary has been her best friend for 21 years. After Rose learns from her PCP that she has the beginning signs of dementia, she decides to make Mary her healthcare proxy (HCP).
Since 1999, more than 760,000 Americans have died from a drug overdose—the vast majority of them related to an opioid. Hospitals and case managers have found themselves on the front lines of the crisis.
Case managers play an important role both inside the hospital and working with outpatients. But often they work in isolation, rather than coordinating care between the settings to improve patient outcomes.
