TOTAL CASE MANAGEMENT
ED, Outpatient, and Hospital
Total case management provides better patient care while generating revenue for the healthcare entity. Total case management incorporates the Emergency Department, Hospital, Clinics, and Long Term Care. Coordinating all these resources increases NET REVENUE by $500,000 a year at minimum.
Total Case Management
Return on Investment
- Increased Admissions and Observations
- Increased Inpatient and Outpatient Revenue
- Improved Patient Care Coordination
- Reduced Emergency Room Return Visits
- Increased Patient Satisfaction
- Reduction in Uncompensated Care in ED
Initial Total Case Management Implementation Stats
Volume and Revenue Increase
| Referral Type | Volume of Referrals Receiving the Service | Difference from Usual Referral Pattern | Net Revenue |
|---|---|---|---|
| Inpatient | 150 | 75 | $511,425 |
| Observation | 130 | 60 | $189,140 |
| Swing Bed | 75 | 37 | $1,207,500 |
| Follow Up Visits | 1200 | 450 | $67,500 |
| Surgery (general and ortho) | 18 | NA | $72,000 |
| Ancillary (stress testing, echo, US) | 20 | NA | $75,000 |
| Rehabilitation Services | 30 | NA | $24,300 |
| Cardiopulmonary Rehabilitation | 15 | NA | $28,875 |
| Behavior Health | 10 | NA | $43,560 |
| Home Health or Hospice | 20 | NA | $56,000 |
| CCM | 1500 | NA | $92,000 |
| CCM Follow Up Visits | 400 | NA | $60,000 |
| Annual Wellness Visits | 480 | NA | $72,000 |
| Total Net Revenue Increased | $2,499,300 | ||
Other Rural Hospital Client Success Stories:
TCM implementation in Critical Access and PPS hospitals has delivered:
Explosive growth in swing bed utilization:
- 140% increase in swing bed admissions and 227% increase in swing bed days within 9 months
Significant ED conversion improvement:
- 60% year-to-date increase in ED to IP/OBS admissions
Immediate volume lift:
- Year-to-date increase of 82 admissions, including 30 OBS and 52 IP admissions
More than 2.5x improvement in admit rate
- ED to IP/OBS admit rate improved to 16%, up from a prior rate of 6%
Patient Outcomes and Satisfaction
- Call Backs to check on patient and identify positive or negative experiences
- Full Circle Care:
- Acute needs often shed light on chronic care issues that often are not addressed in an ED leaving the circle open.“ Treat them and street them.”
- Case management can follow through on meeting those needs so the patient does not fall through the crack and keep having health problems.
- Explanation of care by nonclinical person
- Someone to check on the patient prior to discharge to clear up any concerns or questions.
Since partnering with LTCM’s Total Case Management Program, our ED admission rates have increased by 35% from the prior year. Our patients receive personalized care and education from qualified ED case managers. The program delivers rapid and consistent results.
Billie Bell, RN, MBA, FACHE
Chief Nursing Officer, Medina Regional Hospital
LTCM sets the new standard shifting the paradigm from the typical rural hospital case management model. The LTCM model for total case management engages the entire system where everyone is a stakeholder creating the best outcomes for our patients and staff, and most importantly, the community.
John A. Graves, Ph.D.
Chief Executive Officer, Dimmit Regional Hospital
LTCM Consulting has successfully helped our organization implement Case Management within our Emergency Department. This service has been a tremendous support for patient satisfaction, provider education, and increase in patient admission rate. Our organization alone would not have had the timely results provided by contracting with LTCM!
Lisa Gates, RN BSN
Chief Nursing Officer , Southwest Health Systems
Case Studies
Dallam Hartley Counties Hospital District
DHCHD was a hospital district on the brink of closure, losing over $500,000 per year for the past 12 years. Within two years Loree and her team turned it around resulting in a $1.5 million profit and a $4.8 million reduction…