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What is nursing case-management?


The American Nurse Credentialing Center, a subsidiary of the American Nurses Association (ANA), defines nursing case management as:

... a dynamic and systematic collaborative approach to provide and coordinate health care services to a defined population. The framework…includes…five components: assessment, planning, implementation, evaluation, and interaction. (ANA, 2005)

Nurse case managers actively participate with their clients to identify and facilitate options and services for meeting individuals' health needs, with the goal of decreasing fragmentation and duplication of care, and enhancing quality, cost-effective clinical outcomes. (White & Hall, 2005)

 

WELCOME!

Hello and welcome to my website. My name is John Wallis. I am a registered nurse and have been a licensed nurse for over 13 years. I have a strong background in cardiac/telemetry and critical care. I am certified in basic life support as well as advanced cardiac life support.  I am currently on a travel assignment  which will end July 5, 2008.
My goal for the next five years is 1) To obtain my undergraduate degree in December of this year, 2) Work full time for two years, and 3) Go back to school full time for a degree as an adult  nurse practitioner. (For details of my work history please click on the "my resume" link above left.) To facilitate this goal, I am changing the status of my current position in acute care to one of nurse case manager. I am looking for this position in the Northeastern Ohio area. I have acute care experience, so the perfect position would involve this setting. However, I would be willing to consider, long-term care since I will eventually be working in this setting, or worker's compensation claims. (References are available by request.) Please email me with any questions at john@johnwallis.sandtstaffing.com Thank you for visiting my website and have a good day!

Managed Care

          Managed care continues to evolve, as health care service and as a business. More than 110 million Americans are already enrolled in formal managed care plans. A significant portion of new enrollees are Medicare and Medicaid recipients.

          MCOs, or managed care organizations, is a generic term that encompasses a variety of managed care plan types., such as HMOs (health maintenance organizations), PPOs (preferred provider organizations), IPAs (independent practice arrangement), IDS (integrated delivery systems), or EPOs (exclusive provider organizations) Approximately 75 percent of the nation's physicians now participate in a managed care system. (Mullahy, 2004)


Exclusive Survey—Managed Care: Your dependence grows

          Managed care remains a big part of doctors' lives—and their incomes—but they're still wary of accepting a fixed monthly amount for each patient they see. That's one of several eye-catching findings from the latest Medical Economics Continuing Survey, which asked office-based MDs and DOs about their participation in managed care and capitation.

          For those respondents who took any managed care last year, revenue from HMOs and PPOs constituted a median 60 percent of practice revenue, while capitation revenue for those who accepted any capitation made up only 20 percent of collections after all adjustments, discounts, and write-offs. (Guglielmo, W., 2005) Read More

 

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Resources

Mapping the literature of case management nursing:

Case management is a care delivery model designed to coordinate and manage patient care across the continuum of health care systems. Case managers are usually involved over an “entire episode of illness/ disability or need for services”. (White & Hall, 2005) Read more


How will the Nurse Case Manager help my patient?

While the role of health professionals is to diagnose and prescribe treatment, the primary role of the Nurse Case Manager is to coordinate and facilitate care. (Work safety and insurance board, 2008) Read More


Philosophy of case management:

Case management is an area of specialty practice within one's health and human services profession. Its underlying premise is that everyone benefits when clients reach their optimum level of wellness, self-management, and functional capability: the clients being served; their support systems; the health care delivery systems; and the various payer sources.

(CCMC, 2008) Read More

 

 

 

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