2. Reducing readmission risks
Case managers make a bottom-line difference in healthcare organizations because they have a keen focus on improving care coordination and eliminating gaps in care that lead to unnecessary readmissions, according to the Commission for Case Manager Certification. Here's an example. Last fall, physician executives from Aetna wrote about how the health insurer was using case managers to improve outcomes for 750 Medicare beneficiaries in a collaboration withNovaHealth, a physician group in Portland, Maine. In the article in the September 2012 Health Affairs, the authors reported 56 percent fewer readmissions than statewide unmanaged Medicare populations, and the total per member per month costs for Aetna's Medicare members were 16.5 percent to 33 percent lower than costs for other members, the authors wrote.