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Case management is a managed care technique within the health care coverage system of the United States. It involves an integrated system that manages the delivery of comprehensive healthcare services for enrolled patients. [1] Case managers are employed in almost every aspect of health care and these employ different approaches in the control ...
Medical case management requires the evaluation of a medical condition, developing and implementing a plan of care, coordinating medical resources, communicated healthcare needs to the individual, monitors an individual's progress and promotes cost-effective care. The term also has usage in the USA health care system, referring to the case ...
Definition. A clinical pathway is a multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced either by hour (ED), day (acute care) or ...
Case management is the coordination of community-based services by a professional or team to provide quality mental health care customized accordingly to individual patients' setbacks or persistent challenges and aid them to their recovery. [1] [2] Case management seeks to reduce hospitalizations and support individuals' recovery through an ...
The term managed care or managed healthcare is used in the United States to describe a group of activities intended to reduce the cost of providing health care and providing American health insurance while improving the quality of that care ("managed care techniques"). It has become the predominant system of delivering and receiving American ...
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
CMS surveyors will visit the state hospital starting Feb. 25 to ensure the plan of corrective action is successfully being implemented. The hospital's plan of corrective action includes:
Utilization management is "a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision," as defined by the Institute of Medicine [1] Committee on Utilization Management by Third Parties (1989; IOM is now the National ...