Nurse Case Management Model
During the end of this summary, I am requested to write a term paper of analysis of nursing care delivery model. I am a case manager so I would like to write a paper of nurse case management in this term paper.
When I first touched the consent of nurse case management, I was a home care nurse so the idea of nurse case management totally was blind to you.
According to American Case Management Association (ACMA), “Case Management in Hospital/Health Care System is a collaborative practice model including patients, nurses, social workers, physicians, other practitioners, caregivers and the community.” (ACMA, 2015) Case management is a care coordination and care management to patients in the safety and security of their …show more content…
The Pros of MLTC is to provide long-term care service to keep enrollees at home and community as long as possible. Also, MLTC program is cost and effective to manage Medicaid. All durable medical equipment’s applications need to send to plan that consumers have enrolled to get approval so that every dollar will be spent on the items that consumers really need. According to “The Long term Care Community Coalition(2013), “Care for nursing home residents, among our most vulnerable New Yorkers, makes up close to one third of Medicaid spending on long term care. In fact, nearly half of all nursing home residents are “dually eligible” for Medicare and Medicaid. Thus, the inclusion of nursing home care in Medicaid redesign provides an opportunity for the state to save significant …show more content…
In other words, consumers need to be compliant with their plan’s policy. According to “The Long term Care Community Coalition (2013), “The manner in which New York is implementing Medicaid redesign is by shifting the program from “fee for service” to Mandatory Long Term Care.” Before implementing MLTC problem, Medicaid pays for covered services when costs for those services are incurred under fee for service. Under Managed Long Term Care (MLTC), the state will pay insurance companies at specific overall rates to cover the expenses for their pan’s beneficiaries. Consumers need to get the approval for insurance first, and then they can get the service. Being enrolled to MLTC program, they have some limitation from insurance. Also, enrollees need to choose the providers that have contract with their plan. For example, consumers need to be admitted to a nursing facility for a long term placement so that they need to use the nursing facility in their plan’s network. Otherwise, consumers need to be disenrolled from current
During the end of this summary, I am requested to write a term paper of analysis of nursing care delivery model. I am a case manager so I would like to write a paper of nurse case management in this term paper.
When I first touched the consent of nurse case management, I was a home care nurse so the idea of nurse case management totally was blind to you.
According to American Case Management Association (ACMA), “Case Management in Hospital/Health Care System is a collaborative practice model including patients, nurses, social workers, physicians, other practitioners, caregivers and the community.” (ACMA, 2015) Case management is a care coordination and care management to patients in the safety and security of their …show more content…
The Pros of MLTC is to provide long-term care service to keep enrollees at home and community as long as possible. Also, MLTC program is cost and effective to manage Medicaid. All durable medical equipment’s applications need to send to plan that consumers have enrolled to get approval so that every dollar will be spent on the items that consumers really need. According to “The Long term Care Community Coalition(2013), “Care for nursing home residents, among our most vulnerable New Yorkers, makes up close to one third of Medicaid spending on long term care. In fact, nearly half of all nursing home residents are “dually eligible” for Medicare and Medicaid. Thus, the inclusion of nursing home care in Medicaid redesign provides an opportunity for the state to save significant …show more content…
In other words, consumers need to be compliant with their plan’s policy. According to “The Long term Care Community Coalition (2013), “The manner in which New York is implementing Medicaid redesign is by shifting the program from “fee for service” to Mandatory Long Term Care.” Before implementing MLTC problem, Medicaid pays for covered services when costs for those services are incurred under fee for service. Under Managed Long Term Care (MLTC), the state will pay insurance companies at specific overall rates to cover the expenses for their pan’s beneficiaries. Consumers need to get the approval for insurance first, and then they can get the service. Being enrolled to MLTC program, they have some limitation from insurance. Also, enrollees need to choose the providers that have contract with their plan. For example, consumers need to be admitted to a nursing facility for a long term placement so that they need to use the nursing facility in their plan’s network. Otherwise, consumers need to be disenrolled from current