Valuing Quality Through Care Management

Care Management ensures the quality of patient care with measurable outcomes and Quality Cycle Management (QCM)

Accomplish effective Care Management by using a multi-disciplinary team to provide coordinated care for high-risk patient populations. Quality Cycle Management (QCM) lays the foundation for the agency to provide Care Management. How? Through coordinated workflow processes and operations that follow the patient’s every step along the post-acute journey. This requires processes that place the patient at the center of the care team and follow evidenced-based best practices in the delivery of that care.

Care Management requires:

  • Identification
  • Stratification
  • Prioritization of patient care per episode

Technology and clinical interventions can help with this. True Care Management goes across transitional care, episodic care, and potential palliative care. This is accomplished via engagement with the patient, caregiver, coaching, education, interdisciplinary communication, and patient outreach. It is cost-effective, practices non-duplication of services, and allows clinicians to provide optimal quality of care. Why? To achieve patients’ optimal level of wellness.

As healthcare changes continue to evolve, there are three things that will not change:

  1. The requirement to have improved clinical outcomes
  2. Patient care at less cost
  3. Increased patient satisfaction

Providing Care Management to each patient on an individualized basis will position an agency for Value-Based Reimbursement Arrangements with payers and provides a bottom line that supports the agency into expanding services. In addition, and perhaps most importantly, it creates an environment for greater staff and patient satisfaction. 

Must Do for Care Management:

  • Have an EMR – No more paper!
  • Track analytical data
  • Rehospitalization risk tool
  • Focus on the patient and fostering a partner-like relationship with each individual patient 

What does Care Management mean to my agency?

Care Management meets IMPACT ACT goals of:

  • Safe care
  • Involvement of patient/caregiver
  • Coordination and communications internally and externally
  • Promoting healthy living in the community
  • Improving outcomes for patients under your care.

Agencies must plan for each patient to have an interdisciplinary team that works to establish patient goals and develops a care plan from established goals for each individual patient. They must work to improve each individual patient’s functional health status. Also, agencies must improve coordination of care across the continuum.

Furthermore, care management works to decrease opportunities for duplication of services and health care delivery system costs. These goals, plus ensuring that patients engage in self-care all serve for improved patient outcomes and progression in Star Ratings.

“Quality has and always will be our most important value.” -Laura Page-Greifinger, CEO/President/Founder

In conclusion, QCM lays the foundation for overall agency quality by creating the workflow process for Care Management to happen and to succeed. It sets the steps in place to achieve best practice and monitors through data collection and analysis the outcomes of the provision of care; which is what agencies need to focus on.

QIRT’s use of QCM has made us uniquely suited to advise on quality.

QIRT provides the tools and expertise agencies… for success with Care Managment and continued success overall.

Join us for a free webinar on September 20, 2018. 1pm EST: Care Management: Highlighting Value in the Post-Acute Care Industry. 


Contact QIRT today for more information.

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