Case and Care Management

Case Management

Case management plays a crucial role in the modern healthcare system, especially in the midst of the COVID-19 pandemic. Case managers guide patients through the system, determine a patient’s health situation, build relationships between providers and patients, ensure essential care is delivered, increase the quality of services provided by healthcare organizations, conduct contact tracing, and coordinate care at each level.

Basically, case management reduces fragmentation by serving as a direct line of communication between the patient and the health personnel treating them.

This type of value-based care requires a significant focus on data collection, information exchange and care coordination — all services that may put a strain on your practice’s current internal staff. HealthCare Resolution Services offers outsourced case management services for providers looking to create or maintain a value-based case management program. 

Why Outsource Case Management?

Effective case management ensures that your healthcare organization does not fall short on quality services. This focus on quality is an essential aspect of remaining competitive in the marketplace in terms of patient retention, reimbursements and value-based care. Outsourcing case management is an increasingly popular option for healthcare organizations across the country. In fact, 80% of hospitals that entrust these functions to a professional services firm report that service levels exceed their expectations.

Outsourced case management can increase efficiencies across the board and provide your healthcare organization with a number of distinct benefits, such as:

• Helping healthcare organizations achieve goals: Establishing a case management program is an intensive process in terms of labor, time and financial resources. Instead of recruiting and training the needed staff, outsourcing allows you to take advantage of an established case management team who will adopt your healthcare organization’s goals. 
• Ensuring cost-effective care: Effective case management creates savings by reducing a patient’s length of stay, preventing unnecessary treatment, properly utilizing resources and lowering hospital readmission rates. 
• Providing a clear ROI: While case management may not directly contribute to reimbursements, the services provided have a clear ROI. Outsourced, effective case management allows for timely discharge and reduced lengths of stay. Your case management team can also work with the revenue cycle team to ensure clean claims, and their services contribute to excellent ratings from patients.
• Easily measuring patient outcomes: Many readmissions could have been prevented with better care coordination. An effective case management program guides patients through their continuum of care, ensuring services are tailored to their exact needs. The outcome is a measurable increase in patient satisfaction rates. 
• Measuring quality of care: Case management serves as a vital communication resource that coordinates between providers and offers an integrated approach. This approach ultimately influences health outcomes and the quality of care provided. 

Care Management

Chronic conditions continue to rise in the United States. To offer life-saving services and the best possible care for patients, many healthcare organizations have adopted Chronic Care Management, or CCM. This service gives providers the tools and structure they need to simplify care, increase patient engagement and help patients understand and take charge of their health. CCM also helps providers address their bottom line and grow as an organization. 

Providing CCM independently requires a significant investment of time and resources. Outsourcing Chronic Care Management to the team of qualified experts at HealthCare Resolution Services ensures the program runs smoothly and helps it achieve overall success. 

Why Outsource Care Management?

Most practices and healthcare organizations attempt to start the Chronic Care Management process internally. Unfortunately, this plan does not allow you to achieve your full potential for two main reasons. First, internal staff members already have a lot of other tasks to manage. As a result, they’re constantly pulled away from your CCM program. It can also be expensive to recruit and train designated CCM coordinators, which can minimize ROI. 

Outsourcing your Chronic Care Management plan to HCRS presents an enormous opportunity to enhance the care of at-risk patients. Plus, contracting coordinators to act as an extension of your organization can provide you with incredible benefits. You can:

• Generate greater revenue: CCM provides practices with a completely new revenue stream. Reimbursements for these services can earn your organization tens of thousands of dollars per year per billing provider. Outsourcing ensures you are providing patients with the appropriate services to successfully earn those reimbursements. Plus, outsourcing allows you to provide CCM services to eligible patients without the costs associated with building this service from scratch. 
• Increase patient participation: Patients with multiple chronic conditions often find it difficult to keep track of their different providers. When you outsource your CCM services to HCRS, patients are paired with a dedicated care team member who establishes a meaningful relationship with them and conducts monthly check-in phone calls to review their care plan.
• Improve your focus on face-to-face care: Outsourcing CCM services peripheral to your organization’s primary operations enables staff to focus on core concerns, such as face-to-face interactions between your practice and your patients. 
• Help patients follow their treatment plans: Following up is an essential aspect of patient care. Outsourcing care management ensures patients have the opportunity to speak with a dedicated care manager. We can plug patients into their patient portal, help them keep track of medications, obtain basic vitals and provide the advice they need to follow their treatment plans. 
• Decrease administrative strain: Introducing any new service into your organization can create an administrative strain on your internal staff. The amount of administrative work associated with CCM can be staggering. Outsourcing transfers many of these responsibilities to a trusted health information management provider. 

Our Mission 

At HCRS, our mission is to help healthcare organizations improve data quality, overall organizational performance and program outcomes, including Chronic Care Management services and case management.

Choosing to outsource the management of your CCM program or case management is a critical decision — both financially and for the overall wellbeing of your patients. With over two decades of experience, HCRS has the proven skills and industry knowledge to provide your CCM patients with in-depth, personalized care. Let us help you manage your chronic care plans and improve case management performance. Contact us today to learn more.