Phoenix Medical Management, Inc. Outcome Model

Contemporary Hospital Case Management

Changes in the marketplace must drive changes in the hospital's care management program. Contemporary outcome models include best practices that work in FFS and value based care environments.

Today, hospital case management describes a compilation of activities typically found under the case management program umbrella. Accompanying that evolving shift, is the movement from functional models focused on the tasks related to utilization review and discharge planning activities to the application of population health principles as the patient journeys through the continuum of care. In keeping with the marketplace shift from FFS to value based care, case management programs must generate sustainable outcomes by pro-actively orchestrating progression-of-care in collaboration with the physician and healthcare team. These outcomes can be measured to demonstrate success.

  • Seamless progression-of-care
  • Improve delivery of care processes
  • Orchestrate team support for safety and quality
  • Promote safe transitions-of-care
  • Influence responsible use of resources
  • Reduce risk, fragmentation and inefficiencies
  • Pro-actively advocate for patients
  • Channel selected patient to Transitional Care programs for short term monitoring in the community

The degree to which measurable goals are attained rather than the completion of tasks is the strategic intent of any venue of care management practice and it is the heart of successful hospital care management practice