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.

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.