SOLUTIONS 100% 2023/2024
Managed Care
Systems-oriented and involves the management of various benefits of health insurance plans
The evaluation and case closure domain of case management involves
Reporting termination to services to stakeholders
One purpose of case management practice is
To promote informed decision-making by the patient and others by interjecting objectivity and
information
Acute Care Case Management Model
NCM Identifies acute care needs and discharge requirements in addition to developing the treatment
plan along with members of IDT.
NCM follows patient from admission to discharge
Complete-based
NCM acts as a liason between care levels to assist the patient during the convalescent (recovery)
period by assessing his or her condition and determining appropriate services in
Skilled nursing facility case management model
Benefit of working as an independent/private case management midel
Flexibility and autonomy in decision-making
Value calculated by multiplying the relative weight and the facility's base rate
Hospital payment
Affects case load index
Severity of illness, need for intervention, and treatment difficulty
Major diagnostic categories (MDCs) are
Grouped according to anatomical and pathophysiological sections
Calculation used to identify variables in various settings that affect caseload is