In addition, specialty case management services provide clinical expertise in the areas of high-tech care as well as behavioral and substance abuse conditions. Associate medical directors are available for consultation on those cases which may be subject to discussion. Case Management Nurses with critical care expertise provide high tech care management for those patients with complex clinical needs. A multidisciplinary approach is taken to ensure that patients who are medically compromised will have their needs met from the acute care setting through discharge. The scope of this program covers transplants, premature births, traumatic multisystem injuries, or a debilitating medical condition.
Nurses have on-site privileges at several contracted hospitals to allow for active case management.
Sub-acute units and skilled nursing facilities are now providing specific types of health care services to members requiring skilled services outside of the traditional hospital setting. This program enables nurses to coordinate emergency care, facilitate access to a patient's PCP, and support the concept of continuity of care. This program is active after normal business hours, on weekends, and holidays. Technology To effectively utilize health care dollars, HAP staff also use the latest technology to find the most high quality, efficient ways of providing care. Episode Profiler is a computer program that compares practice patterns of physicians in treating certain diseases to obtain the average cost for care.