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Scooped by
American Institute Health Care Professionals
onto Case Management in Health Care March 11, 3:48 PM
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Scooped by
American Institute Health Care Professionals
onto Case Management in Health Care March 11, 3:48 PM
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Inside healthcare AI's toughest challenge: Predicting reimbursement before denials occur.
American Institute Health Care Professionals's insight:
Why utilization management is one of healthcare AI’s hardest problems
Utilization management Please also review AIHCP's Case Management Certification.
Clinical care resilience is just as important as other policies that support uninterrupted care delivery. Learn how to reduce operational disruptions here.
American Institute Health Care Professionals's insight:
The Importance of Clinical Care Resilience Planning | HealthTech Magazine
Resilience Please also review AIHCP's Case management program
Value-based care has entered the mainstream. The latest national measurement from AHIP found that nearly 45% of U.S. healthcare payments flowed through
American Institute Health Care Professionals's insight:
Same contract, different results: What separates value-based care performers
Value based Please also review AIHCP's Case Management Program
Deciding whether a patient can safely recover at home, at a skilled nursing facility, a hospital or other setting can be crucial for recovery. Routing
American Institute Health Care Professionals's insight:
Site Of Care Decisions: How Referral Partners Weigh Home Health, SNFs
Site decisions for care Please also review AIHCP's Case Management Program
Hospitals are leveraging state-of-the-art command centers to drive operational efficiency and improve patient outcomes.
American Institute Health Care Professionals's insight:
Health Systems With Centers Excel in Care Coordination | HealthTech Magazine
Exceling in care Please also review AIHCP's Case Management Certification
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
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
From
poddtoppen
What if there were a free, portable tool you could use almost anywhere to help reduce stress and emotional overwhelm?
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
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 […]
American Institute Health Care Professionals's insight:
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
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
From
www
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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Exploring models of integrated care for patients receiving active cancer treatment in the community
American Institute Health Care Professionals's insight:
Exploring models of integrated care for patients receiving active cancer treatment in the community
Better models Please also review AIHCP's Case management program
What Went Right? Nurse case managers work at the intersection of medical care, function, communication, and return to work. They may enter a claim when treatment becomes complex, recovery stalls, multiple providers become involved, or additional coordination can help move the process forward. Their work frequently happens between the visible milestones recorded on a claim. | WorkersCompensation.com
American Institute Health Care Professionals's insight:
The Nurse Case Manager: Recognizing Progress Along the Recovery Journey - WorkersCompensation.com
Nursing and case management Please also review AIHCP's Case Management Program
Ochsner Health shows how coordinated home care can reduce readmissions, smooth transitions and keep patients from returning to the hospital.
American Institute Health Care Professionals's insight:
Better handoffs help home care cut hospital readmissions
Cutting hospital readmissions Please also review AIHCP's Case Management Certification
Physician advisors underrecognized force improves healthcare efficiency, revenue integrity, and value-based care in health systems.
American Institute Health Care Professionals's insight:
Physician advisors: an underrecognized force in improving healthcare efficiency and value
Improving healthcare efficacy Please also review AIHCP's Case Management Program
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
From
www
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:
From
www
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
From
www
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
From
www
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
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
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
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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The New Era of Coordinated Virtual Care: From Point Solutions to Integrated Ecosystems
Coordinated care
Please also review AIHCP's Case Management Program