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Related Concept Videos

Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Dosage Regimen: Individualization01:24

Dosage Regimen: Individualization

Individualization in dosing regimens is the customization of medication doses for individual patients. Its necessity arises from the goal of maximizing therapeutic benefits while minimizing risks. This approach is pivotal because human responses to drugs can vary widely; what is effective for one person may be inadequate or excessive for another. Interpatient (intersubject) variability refers to differences in drug responses between individuals, while intrapatient (intrasubject) variability...
Documentation in Long-Term and Home Healthcare Setting01:29

Documentation in Long-Term and Home Healthcare Setting

Documentation in long-term care facilities and home healthcare settings is crucial for ensuring continuous, coordinated, and comprehensive care for patients. Each setting has its specific documentation processes and tools:
Long-Term Care Facilities
Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is limited...
Dosage Regimens: Designs and Approaches01:28

Dosage Regimens: Designs and Approaches

Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...
Pharmaceutical Alternatives: Polymorphic Form-Related and Particle Size-Related Therapeutic Nonequivalence01:27

Pharmaceutical Alternatives: Polymorphic Form-Related and Particle Size-Related Therapeutic Nonequivalence

Changes in polymorphic forms can significantly influence the bioavailability of poorly soluble drugs. Although the FDA defines pharmaceutical equivalence based on having the same active ingredient, dosage form, and route of administration, it does not automatically disqualify products with different polymorphic forms. This means two products with different polymorphs can still be deemed pharmaceutically equivalent. However, polymorphic differences can affect properties like wettability,...

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Related Experiment Video

Updated: Jul 7, 2026

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
06:59

A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings

Published on: November 9, 2016

Retooling for managed care: one size does not fit all!

Kristy Wright1, Liz Powell

  • 1VNA Services and Foundation, Western Pennsylvania, USA. kwright@vna.com

Caring : National Association for Home Care Magazine
|March 4, 2008
PubMed
Summary

Patient admission rates for Medicare Advantage (MA) to Prescription Drug Plans (PDPs) under 30% are manageable. Higher MA to PDP admission percentages (40-50%+) significantly disrupt operations and finances, necessitating major organizational changes.

Area of Science:

  • Healthcare Management
  • Health Services Research
  • Health Economics

Background:

  • The increasing prevalence of Medicare Advantage (MA) plans presents unique operational and financial challenges for healthcare organizations.
  • Understanding the threshold for patient admission from MA to Prescription Drug Plans (PDPs) is crucial for effective resource allocation and risk management.

Purpose of the Study:

  • To determine the impact of Medicare Advantage (MA) patient admission rates to Prescription Drug Plans (PDPs) on healthcare operational systems and financial stability.
  • To identify critical thresholds for MA to PDP patient admissions that necessitate significant operational and financial adjustments.

Main Methods:

  • Analysis of patient admission data correlating Medicare Advantage (MA) enrollment with Prescription Drug Plan (PDP) utilization.

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  • Assessment of operational disruptions and financial impacts at varying MA to PDP admission percentages (e.g., 30%, 40%, 50%+).
  • Main Results:

    • Admission rates of MA patients to PDPs below 30% are easily managed with minor operational realignments.
    • A 40% MA to PDP admission rate significantly impacts normal operations, requiring substantial changes.
    • Exceeding a 50% MA to PDP admission ratio poses a threat to organizational stability without major adaptive changes.

    Conclusions:

    • Healthcare organizations must monitor MA to PDP admission ratios closely to anticipate and mitigate operational and financial risks.
    • Proactive strategic planning and operational adjustments are essential when MA to PDP admission rates approach or exceed 40%.