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Posts under: Health Management

Talk More – Deny Less

October 2016 Blog, Health Management, The Business of Health Care Comments Off on Talk More – Deny Less

What defines an effective patient management vendor? Is it working in a delegated relationship and issuing denials of inpatient days? How about refusing to approve services that might be helpful in moving a patient out of the hospital to home? Maybe making adverse determinations without discussions with medical care providers?

At ProgenyHealth, we don’t believe that any of those things produce effective or sustainable relationships with providers. Instead, we promote proactive and consistent dialogue with our clients’ providers to anticipate clinical needs and prepare for the next level of care. Our nurses and physicians speak directly with the clinicians in the facilities to discuss the care being provided, barriers to patient progress, and anticipated discharge needs. They discuss the best approach to achieving a healthy outcome and, where possible, address discharge needs early. This proactive and consistent dialogue is one of the primary tenets of the ProgenyHealth medical management model. continue reading

At ProgenyHealth, NICU means Neonatal Intensive Collaboration Unit!

May 2016 Blog, Health Management, Stories from the NICU Comments Off on At ProgenyHealth, NICU means Neonatal Intensive Collaboration Unit!

What is collaboration? Wikipedia defines it as the process of two or more people or organizations working together to realize shared goals. Central to successful collaboration is identification of a common purpose, the shared goal that everyone on the team is working towards.

At ProgenyHealth our mission clearly defines that common purpose:

With passion and a singular focus, we improve the health outcomes of premature and medically complex newborns through provider collaboration and parental engagement.

From the moment a newborn is referred to ProgenyHealth, the family is surrounded by dedicated health care professionals whose focus is supporting them through this difficult time while maximizing their newborn’s health outcomes. This is accomplished through directing the efficient use of clinical resources in a manner that promotes quality health care.

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World Prematurity Day: A Strategy to Impact Care & Costs

November 2015 Blog, Health Management, Stories from the NICU, The Business of Health Care 1 comment

November is Prematurity Awareness Month and today marks World Prematurity Day, where various organizations focus the nation’s attention on premature birth. According to the CDC, last year one in every nine babies was born premature in the United States. That’s approximately 450,000 babies each year.

Premature birth is a major driver of health insurance costs. In 2007, the Institute of Medicine reported that the cost associated with medical and health care services for preterm infants was $16.9 billion, with more than 85 percent of those medical care services delivered in infancy. Comparatively, the average medical cost for a healthy baby is $4,389, but for a premature baby it jumps to $54,194. That is a considerable difference. One strategy to reduce costs is to work with a team of NICU experts who can manage the ongoing care management needs of these high risk infants and their families. At ProgenyHealth, we feel that there is a significant opportunity to simultaneously improve outcomes and reduce the costs to the health care system.

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Christmas in July: Bringing Christmas to the NICU Every Day

July 2015 Health Management Comments Off on Christmas in July: Bringing Christmas to the NICU Every Day

An amazing phenomenon occurs in the Neonatal Intensive Care Unit (NICU) as Christmas approaches. Most neonatologists in the hospital will tell you that invariably the Average Length of Stay (ALOS) goes down by a few days. Some doctors have confirmed that, when appropriate, they even promise families that they will do their best to continue reading

High-Risk Maternity Management is Just Half the Story

May 2015 Blog, Health Management, The Business of Health Care, Uncategorized Comments Off on High-Risk Maternity Management is Just Half the Story

When I speak with Health Plan Executives or Medicaid Directors about managing the NICU population, their first response is often to share what they are doing to engage high-risk moms or to reduce early elective C-Sections. Certainly, any baby who is carried to full term and avoids the NICU is a “win” for all. Yet, solely focusing on reducing NICU admissions through prenatal programs misses a significant opportunity to help the costly vulnerable NICU population after birth with continuity of care. continue reading