What Is the Real Objective of Case Management Quality of Care vs Essay

What Is the Real Objective of national Management Quality of Care vs. Reduced Costs - Essay ExampleHowever, it is questionable whether these systems can flip both quality and low costs. By coordinating the wellness thrill needs of a patient requiring four-fold services from multiple providers, studies of disease direction schedules gather in shown that these programs do improve quality by offer interventions such(prenominal) as pre-recorded telephone reminders or home visits by medical professionals (Rand Corporation Study).According to the Rand study, conditions such as diabetes and congestive heart failure (CHF) benefited from case management and reduced costs by decrease hospital admissions, while patients suffering from depression were more apt to use outpatient services and prescription drugs, increase costs. Six chronic conditions were analyzed in the study CHF, coronary artery disease (CAD), diabetes, asthma, depression, and chronic hindering pulmonary disease (COPD). Improved quality was found in four of the six illnesses, with inconclusive results for asthma and COPD. Long-term health outcomes have not been determined, however, because the study covered only one year.In a one-year study by Michael Long, professor at Wichita State University, geriatric patients who were at least 75 and functionall(a)y impaired were randomly assigned to a regular-assist group or a case-managed group. The polish was to refuse the fragmented care that often exists for these patients. Both benefits and costs must be taken into consideration forwards determining success or failure in such a patient advocacy program (Long). The goal should be set by a team and success determined by whether the goal is met. In Longs study, the case-managed group benefited more than the regular-care group, and improved quality was the result. Cost and quality are sometimes considered debate factors, but Long considers this too simple an explanation. He recommends a formula Quality=B enefits - (Risk and Cost), which takes into consideration all the factors involved in case management programs.Limitations of Case Management ProgramsIn a more spread out study, consisting of 46 states examining HMOs and primary care case management (PCCM) programs, the reporting states tended to emphasize utilization results over quality-measure results. In states where many commercial health plans have recently abandoned Medicaid contracts and some rural areas of the United States have been unable to attract health plans, PCCM programs are intelligible from capitated managed care plans in that the Medicaid agency purchases health care services as if it were a health plan (Schneider et al). A comparison of quality oversight PCCM programs and health plans serving Medicaid beneficiaries indicates that states with both have fewer expectations for PCCM programs and do not seem to have a distinct goal. At present, the study found that PCCM programs have not as a rule collected carryi ng out data, thereby lacking the means to improve quality care. Strengths of Case Management ProgramsOne area in which healthcare costs are accelerated is with the high number of diabetics needing treatment, and case management is highly recommended for glycemic date in these patients. As noted by The Guide to Community Preventive Services online, Diabetes management is intricate and difficult for both patient and healthcare provider, and traditional healthcare delivery methods have not adequately met their needs (Case Management Interventions). The Guide goes on to say that a systematic review shows case management delivered as part of disease management to be effective in adults with Type 2 diabetes. Managed care strategies for Medicaid populations in Florida, North Carolina, and