Total Case Management
ED, Outpatient, and Hospital
Total case management provides better patient care while generating revenue for the healthcare entity. Total case management incorporates the Emergency Department, Hospital, Clinics, and Long Term Care. Coordinating all these resources increases NET REVENUE by $500,000 a year at minimum.
Total Case Management
Return on Investment
- Increased Admissions and Observations
- Increased Inpatient and Outpatient Revenue
- Improved Patient Care Coordination
- Reduced Emergency Room Return Visits
- Increased Patient Satisfaction
- Reduction in Uncompensated Care in ED
Six Month Volume and Revenue
| Referral Type | Volume of Referrals Receiving the Service |
Difference from Usual Referral Pattern | Gross Revenue | Net Revenue |
|---|---|---|---|---|
| Inpatient | 73 | 36 | $218,000 | $109,000 |
| Observation | 64 | 45 | $89,000 | $44,500 |
| Follow Up Visits | 600 | 300 | $54,000 | $27,000 |
| OB | 19 | NA | $95,000 | $47,500 |
| Surgery | 9 | NA | $73,000 | 36,500 |
| Ancillary | 25 | NA | $74,000 | 37,000 |
| Home Health & Behavioral Health | 20 | NA | $66,000 | 33,000 |
| Total Revenue | $669,000 | $334,500 |
Patient Outcomes and Satisfaction
- Call Backs to check on patient and identify positive or negative experiences
- Full Circle Care:
– Acute needs often shed light on chronic care issues that often are not addressed in an ED leaving the circle open.“ Treat them and street them.”
– Case management can follow through on meeting those needs so the patient does not fall through the crack and keep having health problems.
- Explanation of care by nonclinical person
- Someone to check on the patient prior to discharge to clear up any concerns or questions.
Case Studies
Dallam Hartley Counties Hospital District
DHCHD was a hospital district on the brink of closure, losing over $500,000 per year for the past 12 years. Within two years Loree and her team turned it around resulting in a $1.5 million profit and a $4.8 million reduction…
