Entry Point Case Management Programs
Appropriateness of hospitalization and the utilization of inpatient and/or observation care is under the microscope of payers, both government and commercial, in attempts to confront the growing cost of healthcare, for payers and providers. A hospital bed is a precious commodity and, equally challenging, access to these beds in a timely manner has become a source of stress for hospitals who are struggling with capacity issues. A strong case management program will ensure that all patient access points have appropriate mechanisms in place to provide surveillance for medical necessity, but also offer patient-centered support in evaluating the patients’ needs and, if hospitalization is not needed, work with patients and families to offer alternative solutions.
The Center for Case Management consultants will evaluate all points of entry to ensure effective and efficient support at the front end of care.
Access Point Case Management Programs
* Provides for timely medical necessity surveillance
* Mitigates or reduces ambulatory sensitive admissions
* Solves for social observation placement
* Provides a more complete psychosocial on complex cases
* Reduces status changes
* Improves capacity and flow in the emergency departments and hospital