Bringing back the doctor house call: Only 1% to 3% of your seniors are probably homebound frail elderly, but they're responsible for exorbitantly high costs. Unable to make office visits, they're at high risk for ER visits and hospitalization. The answer to improving their care and reigning in their costs are regular doctor house calls, say two physicians who practice in-home primary care. Here's why, plus details on their innovative program.
Graduating to Medicaid preventive care management: After nearly 15 years in Medicaid risk contracting, Arizona health system's Medicaid plan discovers that acute care management doesn't cut it anymore, and moves toward proactive preventive care management that's already producing better outcomes and is expected to save millions.
Data File: Medicare inpatient utilization benchmarks. Actuarial consultants Milliman & Robertson find 53% of Medicare inpatient bed days nationally are medically unnecessary or better spent in other health care settings. Here are benchmark data on inpatient admission and bed days per 1,000 members in optimally managed health systems.
Jumping into Medicare risk without a life preserver: What happens when a provider enters a Medicare risk contract with no real case management program? It loses lots of money, as this Alabama provider has learned the hard way. Find out what this provider learned after losing millions--and how officials are correcting some fatal flaws.
Develop a Medicare risk strategy based on your organization's strengths: If you think your only choice is to develop a PSO or remain a simple contractor, guess again. There are lots of strategic and contracting options for providers seeking to boost their profitability and gain more control over their Medicare lives. Learn how to evaluate your market position and strategies for contracting success.
Medicaid asthma program slashes utilization, costs: After seeing hospital costs for asthma patients running as high as $500,000 a month, Hartford (CT) Hospital launched its own asthma education program for Medicaid members that's cut ER visits in half and hospital admissions by more than two-thirds. Learn why this person-to-person program works.
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