Payer-based case management: perspectives on managing brain-injured patient.
As the payer environment is carved into many segments, each with its own accountability relative to its financial liability, family members, providers, and even other case managers often find it difficult to comprehend the perspectives of the various parties represented. Indeed, one brain injury case I recently evaluated had four payer case managers: one from the patient's health plan, one from a disease management program for his premorbid diabetes, and two from Medicaid-sponsored programs for the disabled. For payer-based case managers, the ubiquitous case manager role confusion compounds product unfamiliarity.
Lowery
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Case Management Intervention Associates, Francestown, N.H., USA.
Ellefson
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Haley
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Shanahan
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Purdy
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D001930:Brain Injuries / Q000534:rehabilitation*; D019090:Case Management / Q000458:organization & administration*; D019468:Disease Management; D006801:Humans; D007349:Insurance, Health, Reimbursement; D007587:Job Description; D008484:Medicaid; D011243:Preferred Provider Organizations; D014481:United States