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Targeted case management interventions across the health continuum are reducing health risks in vulnerable populations and taking aim at inappropriate healthcare utilization. The job description of today's case manager is likely to include home visits, crisis management, quality improvement and health coaching — and may increasingly require co-location at the site of care.

To provide essential background on emerging case manager trends, the Healthcare Intelligence Network has assembled responses to the most frequently raised questions regarding case management in a single comprehensive resource. In the Case Management Answer Book Vol. I: FAQs on Risk Reduction, Care Coordination and Co-Location, industry thought leaders provide answers to more than 50 questions on the practicalities of case management, from required skill sets for newly hired case managers to engaging non-compliant patients to supporting a case manager embedded in a hospital emergency room.

This 30-page resource delivers advice from case management leaders at Geisinger Health System, whose successful embedded case management model is being replicated around the country, as well as other organizations that tackle a range of case management topics in an easy-to-read Q&A format.

A sampling of questions covered in Case Management Answer Book Vol. I: FAQs on Risk Reduction, Care Coordination and Co-Location include:

• Benchmarks:
  • What's the optimal case load for a healthcare case manager?
  • What's the most appropriate nurse-to-PCP office ratio?
  • How do you evaluate case management program ROI?
• Roles and Competencies:
  • What are some essential skills of the ED case manager?
  • How often do case managers update plans of care?
• Care Transitions:
  • How does Geisinger Health Plan handle medication reconciliation in its care transitions?
  • What are some optimal hospital discharge strategies?
  • How do you staff a transitional team?
• Risk-Ranking Populations:
  • How can you case-manage the sick of the sickest?
  • How do you compile a predictive modeling spreadsheet?
  • How do you define a complex case?
• Reducing Avoidable Utilization
  • What case management intervention has helped to reduce hospital readmissions of patients with heart failure?
  • How do you prioritize patients in a high-volume ED?
  • How can case managers help to reduce avoidable ER use?

• Toni Cesta, Ph.D., RN, FAAN, senior vice president of operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, New York;
• Diane Littlewood, RN, BSN, CDE, regional manager of case management for health services at Geisinger Health Plan;
• Rebecca Ramsay, BSN, MPH, senior manager of care support and clinical programs at CareOregon;
• Doreen Salek, director, business operations of health services, Geisinger Health Plan;
• Joann Sciandra, RN, BSN, CCM, regional manager of case management for health services at Geisinger Health Plan;
• Janet Tomcavage, vice president of Health Services, Geisinger Health Plan;
• Jan Van Der Mei, RN, MS, ACM, continuum case management director at Sutter Health Sacramento Sierra Region;