Q: As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) to InterQual. How will this affect organizations, and what can they do to smooth the transition?
Ellen, a case manager, works more than 40 hours every week on-site at her hospital. This has been her schedule since the novel coronavirus (COVID-19) pandemic restrictions were put in place. She is a single mother and decides, despite the virus risk, to work as many hours as possible.
The elimination of the IPO list is planned to be a gradual process that will take three years to fully implement. This year, CMS removed over 300 surgical procedures from the list, primarily cutting the list of musculoskeletal-related procedures, which was reduced from 1,700 to 1,441. The removal of these procedures from the IPO list allows doctors who perform them to be paid for procedures performed on an outpatient basis.
Q: It's easy for case managers to feel overwhelmed during the novel coronavirus (COVID-19) pandemic. The workload has been burdensome for the past year, and many case managers are not able to strike the important work-life balance. What are some recommendations for reducing some of the stress and anxiety that has built up over the past year?
Q: With novel coronavirus (COVID-19) concerns still persisting, patients should be avoiding emergency department (ED) visits when possible. How can case managers help in this process?
The U.S. Department of Health and Human Services (HHS) has extended the current novel coronavirus (COVID-19) public health emergency (PHE), which is good news for organizations.
A vaccination for the novel coronavirus (COVID-19) is finally a reality, and healthcare workers across the country have already rolled up their sleeves for the injection. But polls show that many members of the public may be reticent to do the same when they get the opportunity.
Q: While no one has a crystal ball, I am wondering what changes we might be expecting in the near future as the new administration makes its mark. How might case management be impacted?
Jennifer, who is 37 weeks pregnant, answers her cell phone. She is waiting for John, the case manager from her obstetrician's office, to report her novel coronavirus (COVID-19) test results. She is anxious but believes she knows the results in her heart.
