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onto Case Management in Health Care June 6, 2025 11:38 AM
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In healthcare, accurate and up-to-date provider information is critical for meeting patient care needs and maximizing revenue. It powers everything from provider onboarding and enrollment to patient care coordination and billing. Yet, gathering or maintaining this information is often a significant challenge, taking as long as six months or more. For example, onboarding new physicians […]
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One health system closed utilization management gap by adopting Xsolis' AI-driven Dragonfly platform, improving peer reviews and inpatient appeals.
American Institute Health Care Professionals's insight:
How one health system closed its utilization management visibility gap
Utilization management Please also review AIHCP's Case Management Training
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Burnout in nursing affects nurses’ mental health, job satisfaction, care quality, and patient safety. This collection welcomes original research examining the prevalence, key risk factors, outcomes, and underlying mechanism across nursing settings.
American Institute Health Care Professionals's insight:
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Patient complexity continues to rise due to multimorbidity, co-occurring behavioral health needs, and persistent health-related socia
American Institute Health Care Professionals's insight:
The Value of Research and Evidence-Based Practice... : Professional Case Management
Understanding case management Please also review AIHCP's Case Management Program
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Rural Health Transformation Program Insights (Download) Maternal and child health (MCH) outcomes continue to raise national concern despite ongoing targeted initiatives, community-based interventions, and executive measures aimed at improving population health and saving lives. Although maternal mortality rates have decreased in recent years, the United States has seen maternal deaths well above global rates compared […]
American Institute Health Care Professionals's insight:
Reimagining Rural Maternal and Child Health
Rural hospitals Please also review AIHCP's Case Management Certification
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Discover why nurses should be treated as critical infrastructure and how workforce shortages, retention, and long-term investment impact patient care.
American Institute Health Care Professionals's insight:
Nursing Workforce Challenges: Why Nurses Should Be Treated as Critical Infrastructure
The importance of nurses Please also review AIHCP's Case Management Program
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Experience is broad, created through every interaction an employee has with a leader, a team, a patient, a process and the organization itself.
American Institute Health Care Professionals's insight:
Why patient satisfaction must become a people strategy outcome
Important outcomes Please also review AIHCP's Case Management Program
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Many enrollees don’t know they’ll need to report work, education or volunteer hours starting in less than six months in order to stay covered, according to a recent survey from the Health Management Academy.
American Institute Health Care Professionals's insight:
Over half of Medicaid enrollees say they’re unaware of upcoming work requirements
Understanding Medicaid Please also review AIHCP's Case Management Program
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It is a well-known and well-discussed fact that all of the best decisions are backed by data. In the payer-provider ecosystem, the big areas that use a lot of data-backed decisions are claims management, utilization review, and care coordination. To get a better understanding of the specifics on data analytics' role, we reached out to
American Institute Health Care Professionals's insight:
Improving Claims Management, Utilization Review, and Care Coordination Across Payer-Provider Ecosystems Using Data Analytics | Healthcare IT Today
Improving case management Please also review AIHCP's Case Management Program
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Intelligent patient flow management reduces length of stay and boarding by integrating capacity, admission, and discharge planning with AI-driven insights.
American Institute Health Care Professionals's insight:
Building end-to-end, intelligent patient flow at scale
Patient flow scale Please also review AIHCP's Healthcare Case Management Certification
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Bionic Bloom and Neurodivergent Empowerment Institute Launch Integrated Case Management Services to Close Gaps in Patient Care INDIANAPOLIS, IN / ACCESS Newswir
American Institute Health Care Professionals's insight:
Integrated Case Management Services to Close Gaps in Patient Care
Improving patient care Please also review AIHCP's Case Management Program
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The Case Manager Healthcare in general is undergoing a profound transformation—in this article, I wanted to look at an area many of us don’t think about because we live in an urban or suburban area. Rural areas across the country are set to be hit the hardest as the Big Beautiful Bill is implemented after | WorkersCompensation.com
American Institute Health Care Professionals's insight:
Tips for How Workers’ Compensation Nurse Case Managers Can Prepare for Major Cuts to Rural Healthcare Resources - WorkersCompensation.com
Nurse case managers in rural centers Please also review AIHCP's Case Management Program
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Introduction Older adults experience several transitions in care, which can be challenging and stressful. Transitional care ensures continuity of care by addressing patients’ healthcare needs before discharge and providing ongoing community support. Although transitional care improves patient outcomes and reduces hospital readmissions, its role in addressing mental health (MH) needs in older adults remains underexplored. This scoping review describes the literature on the integration of allied healthcare (AHC) professionals in transitional care for older adults with MH needs. Method Following PRISMA-ScR guidelines, we analyzed 14 peer-reviewed articles (2010–2024) on transitions for older adults with cognitive impairment, dementia, depression, or suicide risk. Thematic analysis identified key roles, lessons, and patient needs in transitional care provided by AHC professionals. Results AHC professionals, including social workers, occupational therapists, pharmacists, and physical therapists, contributed through discharge planning, physiotherapy, medication reviews, MH counseling, and resource navigation. For caregivers, they provided education on dementia care, behavior management, and psychosocial support, improving caregiver well-being and interactions with persons with dementia. Transitional care interventions reduced caregiver stress and, in some cases, hospital readmissions. Challenges included suboptimal medication management for persons with dementia. Key facilitators were flexible delivery methods (e.g., telehealth), tailored interventions, and dementia-specific education. Conclusion AHC professionals are vital to transitional care for older adults with MH needs, offering tailored support to patients and caregivers. Enhanced integration, interdisciplinary collaboration, caregiver education, and addressing systemic barriers could improve care quality. Future research should focus on standardizing interventions and optimizing medication management.
American Institute Health Care Professionals's insight:
Implementing allied healthcare professionals in transitional care for older adults with mental health needs: A scoping review | PLOS One
Helping others find the care they need Please also review AIHCP's Healthcare Case Management Program
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Care managers are overworked. Increased caseloads, complicated patients, and shrinking care teams have made an already challenging job even more difficult. AI
American Institute Health Care Professionals's insight:
How AI Helps Care Managers Do More With Smaller Teams?
AI and case management Please also review AIHCP's Case Management Program
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Even skilled nurses can make mistakes when systems are badly designed. Human factors training could help nurses recognise and reduce these risks.
American Institute Health Care Professionals's insight:
Nurses learn how to care for patients – they should also learn how systems can fail them
Understanding the healthcare system Please also review AIHCP's Healthcare Case Management Program
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What makes patients see care as efficient? Our survey of 254 patients uncovered three insights on communication, access, and coordination that can improve both patient experience and operational performance.
American Institute Health Care Professionals's insight:
The patient perspective: Reframing efficiency in hospital care
Efficacy and Hospital Care Please also review AIHCP's Case Management Program
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From
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What if there were a free, portable tool you could use almost anywhere to help reduce stress and emotional overwhelm?
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Medicaid insurers are counting on pay raises from states about to be squeezed by nearly $1 trillion in federal budget cuts.
American Institute Health Care Professionals's insight:
UnitedHealth, Centene eye Medicaid rebound amid work rules risks - Modern Healthcare
Medicaid Please also review AIHCP's Case Management Courses
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From
medlearn
Advance care planning has always been personal. It is one of the most human conversations that occurs in healthcare. It asks patients, families, caregivers, and clinicians to talk about goals, values, fears, treatment preferences, and what should happen if the patient is no longer able to speak for themselves. But advance care planning is also […]
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The following is a guest article by Adam Byer, Chief Delivery Officer at iTech AG The implementation of technology in healthcare has driven incredible scientific discoveries and improved outcomes. However, the rise of connected devices and integrated systems has also created increasingly complex environments to manage. Historically, healthcare technology management has treated clinical devices as static
American Institute Health Care Professionals's insight:
Transforming Care Delivery Through Clinical Device Management | Healthcare IT Today
Healthcare delivery Please also review AIHCP's Case Management Program
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The No Surprises Act is a federal law designed to protect patients from unexpected medical bills that arise when they unknowingly receive care from
American Institute Health Care Professionals's insight:
Costly Care: Why Healthcare is So Expensive –
The high prices of healthcare Please also review AIHCP's Case Management Program
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At Tallahassee Memorial Hospital, a patient remained in her inpatient room for months after being formally discharged in October 2025. The hospital ultimately filed a lawsuit to have her removed.
American Institute Health Care Professionals's insight:
When a patient is discharged but refuses to leave: Lessons for your practice
Understanding patient discharge Please also review AIHCP's Case Management Program
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Acute surgical and medical emergencies constitute a major cause of morbidity and mortality, placing demands on healthcare systems due to sudden onset, rapid progression, and the requirement for immediate intervention. Optimal outcomes depend on early recognition, structured assessment, and coordinated multidisciplinary care involving emergency medicine, surgical teams, and critical care services. This structured narrative review provides an evidence-informed overview of contemporary approaches to the assessment, diagnosis, and management of acute surgical and medical emergencies, with emphasis on clinically applicable pathways. The review addresses key domains including epidemiology and risk stratification, principles of initial assessment and stabilisation, and diagnostic strategies incorporating laboratory biomarkers and advanced imaging modalities. Management of common acute surgical and medical emergencies is examined, alongside current pharmacological interventions such as antimicrobial therapy, analgesia, sedation, and anticoagulation within high-acuity settings. The role of interdisciplinary integration, post-intervention monitoring, and timely escalation of care is highlighted as a determinant of continuity and outcome optimisation. Emerging innovations, including artificial intelligence-based clinical decision support systems, tele-emergency medicine, and minimally invasive emergency procedures, are discussed for their potential to enhance diagnostic accuracy, triage efficiency, and therapeutic precision. Persistent challenges include heterogeneous presentations, inconsistent guideline implementation, and unequal access to emergency services. Future efforts should prioritize standardized pathways, validated technologies, and integrated care models.
American Institute Health Care Professionals's insight:
Current Approaches to the Management of Acute Surgical and Medical Emergencies: A Structured Narrative Review | Cureus
Please also review AIHCP's Case Management Program
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MedPAC opens April meeting with deliberations on data that will be part of June report to Congress.
American Institute Health Care Professionals's insight:
Medicare: Where does $1.1 trillion go — and where should it go? | Medical Economics
Please also review AIHCP's Case management Program
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When 57-year-old Brooklyn resident Timothy Rhonda visited Park Ridge Family Health Center at NYU Langone with dangerously high blood pressure, he worried he might once again end up in the hospital.
American Institute Health Care Professionals's insight:
Remote monitoring technology helps Brooklyn resident manage high blood pressure
Remote monitoring Please also review AIHCP's Case Management Program
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If there's ever been a team sport in healthcare, it's value based care. As much as a healthcare organization thinks they can do it alone, value based care requires coordination across the entire care continuum. That's the reality that University of Maryland Medical System faced when they were working on their value based care efforts.
American Institute Health Care Professionals's insight:
Value Based Care Benefits of Strong Acute and Post-Acute Care Collaboration | Healthcare IT Today
Value based care Please also review AIHCP's Case Management Program
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Improving Access, Reducing Delays: How AI Is Transforming Provider Data Management
Reducing delays
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