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Title:

Emanuel Medical Center Case Management

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Diabetes Education. Medication non-compliance. Medication assistance ... Gestational Diabetes/Birth Wt. Any pertinent lab values. Clinical Results. Hemoglobin A1c ... – PowerPoint PPT presentation

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Title: Emanuel Medical Center Case Management


1
Emanuel Medical Center Case Management
  • By Deadre Hadden, RN

2
Emanuel Medical Community Case Management
History
  • Program started May 2000.
  • Program started to target the costly uninsured
    frequent flyers of ER.
  • Programs initial frequent flyer charges reduced
    112,586.94 in the 1st year.
  • 382 patients enrolled in Case Management since
    2000.

3
What are the benefits for the hospital?
  • Decrease in re-admissions.
  • Decrease in unnecessary ER visits.
  • Patient compliance.
  • Healthier community.

4
Why are patients referred?
  • Non-compliance of medical treatment
  • Frequent ER visits
  • Education
  • New diagnosis
  • Diabetes Education
  • Medication non-compliance
  • Medication assistance

5
What does the case manager do?
  • Initial home visit
  • Education
  • Screening for needed services
  • Transportation to appointments
  • Frequent phone calls
  • Home visits as needed
  • Food drives

6
Assistance for Case Management Patients
  • A small food bank was established
  • A handicap van was purchased to transport
    patients to various services
  • Coordinated care with Primary Provider
  • Individualized care plan
  • Individualized health education
  • Blood glucose testing machines and strips

7
Continued
  • Free medication through Prescription Assistance
    Programs
  • Screening for the following services
  • Medicaid
  • Food Stamps
  • Energy Assistance
  • Meals on Wheels
  • Access Emanuel
  • Transportation to Appointments
  • DFACS Caseworker

8
What is tracked financially?
  • Emergency Room visits
  • Emergency Room charges
  • In-Patient visits
  • In-Patient charges
  • Out-Patient visits
  • Out-Patient charges

9
How does this work?
  • After being referred into the program, a home
    visit is scheduled. The date of the home visit
    is the initial assessment date. Hospital
    information is collected on the patient for 1
    year back. This is their prior year information
    which is used as a baseline to determine progress.

10
Actual Charges for the Patients in Case
Management
11
Patient Success
  • The most successful patient was a 26 year old
    female with Diabetes Mellitus Type 1 with
    complications of depression, blindness,
    neuropathy and gastroparesis. She was uninsured.
    With the assistance of Case Management she was
    approved for Medicaid.

12
Prior year to implementation of Case Management
Actual Charges
  • 14 ED visits - 19,395
  • 10 Inpatient stays - 110,615
  • 4 Outpatient visits - 6,636
  • Total prior year charges 136,646

13
Charges after 1 Year of Case Management
  • 9 ED visits - 4,510
  • 2 Inpatient stays - 19,284
  • 4 Outpatient visits - 4,265
  • Total charges for year 1 28,059

14
Case Management Year One (1)
  • Prior Year Charges - 782,777
  • Case Management charges - 414,439
  • 76 of the patients experienced reductions in
    charges at Emanuel Medical Center

15
Case Management Year Two (2)
  • Prior year charges - 575,291
  • Case Management charges - 421,185
  • 64 of the patients experienced reductions in
    charges at Emanuel Medical Center

16
Case Management Year Three (3)
  • Prior year charges - 685,263
  • Case Management charges - 386,834
  • 71 of the patients experience reductions in
    charges at Emanuel Medical Center

17
Case Management Year Four (4)
  • Prior year charges - 1,033,774.34
  • Case Management charges - 622,827.27
  • 70 of the patients experienced reductions in
    charges at Emanuel Medical Center

18
What is the criteria to be referred?
  • The patient must be under the care of a Physician
    on Emanuel Medical staff.
  • The patient must have a chronic health condition.

19
Clinical tracking
  • Hemoglobin A1c
  • Total Cholesterol
  • Gestational Diabetes/Birth Wt
  • Any pertinent lab values

20
Clinical Results
  • Hemoglobin A1c
  • Initial HbA1c 10.6
  • Current follow-up HbA1c 8.37

21
Clinical Results
  • Initial Total Cholesterol 230.29
  • 1st follow-up Total Cholesterol 202.33

22
Clinical Results
  • Average birth weight at EMC of neonates born to
    Gestational Diabetic mothers
  • 6.96 lbs.
  • (The national average is 9.1lbs.)

23
Other Components
  • Prescription Assistance programs
  • Most pharmaceutical companies offer
  • free medications to individuals that do not
    have prescription insurance and financially
    qualify based on the Federal Poverty Guidelines.

24
Our Rx Assistance Program
  • Individual must see a participating physician in
    Emanuel County.
  • Individual must have no prescription drug
    coverage.
  • Individual must provide proof of income.
  • Medications are ordered by the Case Management
    Department and shipped to the physicians office
    where they are dispensed.
  • Case Management is responsible for reorders.

25
Since 2001
  • 6,124,791.12 in retail value of prescription
    medications given to the uninsured of Emanuel
    County.
  • 827 individuals served since inception of program.
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