Managing Patient with Multiple Sclerosis (MS)

Case Study: Case Management (100 pts)
This assignment requires a full 3-4 page research report reflecting critical thinking and an analysis of the research findings. Reports must be supported with 3 scholarly creditable outside resources and is to be formatted throughout in accord with APA requirements. Also required are the Title Page, the Main Body, and a Citations page. Papers are to be posted by Saturday at 11:59 PM in the assignment folder titled Case Study. Be sure to reference the competency/student learning outcomes identified in the weekly overview and in the rubric as grading is strictly adhered to the identified competencies.
Topic: Read the following case study published by Prime “Managing Patients with Multiple Sclerosis: The Role of the Case Manager”. Upon reviewing the aspects of this case include in your report the following:
Identify the role and function of the case manager
Identify the needs of the patient and steps to ensure compliance with the care plan
Identify the clinical and non-clinical services needed by the patient
Identify the healthcare providers necessary to participate in developing the plan
Discuss the discharge plan and how it is to be accomplished
Conclude with the quality and cost benefits to the patient, facility and payer.
Case Study
Managing Patients with Multiple Sclerosis: The Role of the Case Manager
Joanna is a 40-year-old female who was diagnosed with multiple sclerosis (MS) 7 years ago after experiencing numbness in her legs and an MRI revealed characteristic brain lesions of demyelinating disease. She was prescribed an interferon (IFN)-beta formulation. Over the last 5 years, MS has affected every aspect of her life. Last year she began to experience increasing physical disability and difficulty driving. As a single mother of 2, she worries constantly that she may no longer be able to work and support her kids. She has not been faithfully adhering to her prescribed IFN regimen because she struggles with the injections. Recently, she experienced a worsening of symptoms including double vision and spasticity in her legs. After several days of experiencing these symptoms, Joanna awoke one morning to find that she could not move her arms or legs normally. She immediately called for an ambulance and was admitted to the hospital.
In the hospital, Joanna was seen by a case manager. After reviewing the patient's medical records and speaking with her about the days leading up to her hospitalization, the case manager contacted Joanna's health insurer and spoke with a managed care case manager. She updated the managed care case manager regarding the admission criteria and inquired about any insurance benefits that may be mobilized post-discharge. The hospital case manager learned that Joanna was eligible for up to 12 physical therapy (PT) visits post-discharge. She requested a PT consult in the chart, knowing that a hospital physical therapist would be in the best position to assess Joanna's current and near-future functional capacity and to mobilize a discharge plan for follow-up PT. The hospital case manager also advised the managed care case manager that Joanna indicated (although did not admit) that she was not faithfully adhering to her treatment regimen. The managed care case manager requested a post-discharge consult by the managed care pharmacist, with a goal to improve Joanna's adherence. Finally, the hospital case manager inquired about whether the health plan had a disease management program. This inquiry prompted the managed care case manager to investigate Joanna's eligibility in the health plan's medication therapy management (MTM) program. Through the MTM program, Joanna would receive patient education resources by email and by mail, as well as regularly scheduled periodic phone calls from a managed care pharmacist to assess her ongoing adherence.
http://primeinc(dot)org/casestudies/casemanager/study/1071/Managing_Patients_with_Multiple_Sclerosis:_The_Role_of_the_Case_Manager (Links to an external site.)