Case Management

Optimizing Outcomes & Controlling Cost 

 
Case Management Services

 
Roughan & Associates. professionals have experience with diagnoses involving both children and adults and are knowledgeable in current treatment philosophies, identification of appropriate resources, and life care planning.


Diagnoses included but not limited to:


 

·         Immunodeficiency Syndrome

·         AIDS Related Complications

·         Amputations

·         Anorexia Nervosa

·         Anoxic Brain Injury

·         Burns

·         Cancer

·         Carpal Tunnel Syndrome

·         Cerebral Palsy

·         Cerebral Vascular Accident

·         Chronic Pain Syndrome

·         Congenital Anomalies

·         Diabetes Mellitus

·         Erbs Palsy

·         Failed Back Syndrome

·         Fractured Hip/Knee/Legs, etc.

·         Guillain Barre’ Syndrome

·         Head Injury - Closed/Open

·         Lymphoma

·         Multiple Sclerosis

·         Myocardial Infarction

·         Near Drowning

·         Organ Transplant

·         Paraplegia/Paraparesis

·       Pulmonary Disease

·         Quadriplegia/Quadparesis

·         Reflex Sympathetic Disorder

·         Soft Tissue Injury

·         Spinal Cord Injury

·         Thrombophlebitis

·         Toxic Exposure

·         Traumatic Brain Injury

·         Traumatic Stress Disorder


Additional referral indicators may include: 


 

·         digression from standard of practice

·         multiple hospital admissions

·         unlimited or high dollar liability

·         unanticipated ICU/CCU confinement

·         evidence of complications, (e.g., infection, decubitus)

·         high claim dollars expenditure

·         multiple treatment providers

·         need for specialized local resources

·         ventilator dependence

·         questions regarding treatment or appropriate care

 

 
Case Management Consulting Services

 

If you are establishing a case management department or practice, we invite you to benefit from our experience and expertise.  A case management department itself is a costly item both in terms of capital expenditure and personnel.  A typical case manager is responsible for medical costs ranging from 15 to 50 Million dollars.  Even small mistakes can be very costly.

   

Roughan & Associates Consulting Services are designed to help you maximize the return on your investment in this vital area of health care cost management and to avoid the costly process of learning by “trial and error”.  Typical issues we are engaged to address include, but are not limited to the following:

 

·         Identifying realistic goals and objectives for case management

·         Designing a case management system and establishing operating procedures

·         Effecting early identification and referral of appropriate cases

·         Training and supervision of a team of case managers

·         Establishing a format for Cost/Benefit Analysis

·         Designing, implementing and maintaining effective management information systems

·         Computerizing and automating the case management department