Purpose/objectives: To share a successful collaborative approach between the medical and behavioral health departments of a managed care organization that improved both utilization rates and management for health plan members with dementia.
Primary practice setting: Acute care hospitals
Findings/conclusions: There was a significant reduction in subsequent hospital admits, beddays, and emergency department visits for this population resulting in a substantial financial savings. Patient outcomes, as well as patient and caregiver satisfaction, was improved.
Implications for case management practice: Prior to the implementation of this pilot, there was a gap in services for health plan members experiencing dangerous behavioral issues associated with their dementia diagnosis. Case management of this population was difficult because of the limited options available in our market area. This innovative program afforded a nontraditional approach to inpatient care that maximized case management possibilities for this population.