Integrated Care Management

Location: Ambulatory Services Building - Suite 1-C24

Hours: 7:30 a.m.- 4:00 p.m. Monday - Friday

Weekend coverage for Discharge Planning:

• Saturday 9:00 a.m.-3:00 p.m.
• Sunday 9:00 a.m. - 4:00 p.m.

Information:

• ICM Administrative Associate: 410-337-1550
• Utilization Review Line: 410-337-1175
• Weekend Line: 410-337-4429
• Outcomes Management: 410-337-1509

The Integrated Care Management Department is comprised of four different components: Social Work, Utilization Review, Case Management and Outcomes Management. These areas work together to provide cost-effective quality of care by monitoring the utilization of resources and providing care coordination services to the patients throughout the continuum of care.

• Social Work: Provides a wide range of social work services to patients and families. Social workers will arrange all post-acute services for patients to include: skilled nursing, hospice, home care, DME and long-term care. Referrals are accepted from all sources: physicians, nurses, patients-families and community agencies. A social worker is assigned to patient units. They are part of the interdisciplinary team and attend discharge planning rounds.

• Utilization Review: Utilization review analysts perform review daily (Monday -Friday) on all patients in the acute care setting using Interqual Criteria. They communicate with third party payors and coordinate denial and appeal activity among the physician, patient and payor. There is a utilization review analyst assigned to every patient unit. They are part of the interdisciplinary team and attend discharge planning rounds.

• Case Management: Case managers are assigned to special populations to coordinate services throughout the continuum of care utilizing a collaborative interdisciplinary process. They are responsible for the utilization management of their assigned patients as well as meeting the identified discharge planning needs of these patients. These case managers are assigned to specific patient population to include: high risk OB and complex pulmonary-medical patients. They are part of the interdisciplinary team and attend discharge planning rounds.

• Outcomes Management: Responsibilities include pathway development, best practice identification, outcomes measurement and education for all staff in collaboration with Performance Improvement.