December 2022

Improving Communications Between Case Managers and Clinicians

BY KEEMIA VAGHEF, PhD, KERRI WIZNER, MPH, AND PAUL M. JACOBSON, JR., BS Receiving timely, accurate and complete information supports case managers in their duty to patients for coordinating care, supporting return to activity and advocating for improved health. Research has shown that communication is a key barrier in slowing down claim processing (reference 1). One common challenge is

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Physician Advisor and Care Management Partnership for Effectively Managing Concurrent Denials

BY ANUJA MOHLA, DO, MBA, CHCQM-PHYADV Physician advisor leadership, in conjunction with case management expertise, can be an effective tool in discharge planning to manage length of stay in an acute care setting. As a physician advisor, I have worked closely with case management leadership for several years to tackle barriers contributing to extended length of

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Identifying At-risk Populations – Case Manager Insights to Behind the Scenes

BY MICHAEL JOHNSON, BSN, RN, HN-BC Case managers have been using electronic systems that identify clients for outreach for many years. Whether daily, weekly or monthly, a list of clients is presented for the case manager to initiate engagement. This is usually based on a combination of the company’s business needs, program construct, regulatory requirements and

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Trends in Digital Innovation Point to a Better Future in Healthcare

BY MARK FRANCIS Digital innovations continue to transform the healthcare landscape. While concerns surround certain aspects of technological advancement, such as data privacy and security, the digital trends we are seeing in the health field are bringing about much-needed, positive change. Since 2020, I have been the chief product officer for Electronic Caregiver, a leading telehealth

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