Estimate case management services based on how much time you believe it will take to coordinate services
Part 2: For this part of the assignment you are to compare the alternate care settings of discharge to home vs. the cost of care in a skilled care facility over a 30 day period. Once you have calculated your costs, complete the following Alternative Care Setting form.
Some costs have been provided and other costs you will have to obtain or estimate. Do not add additional services for equipment.
Estimate case management services based on how much time you believe it will take to coordinate services. For this assignment you do not have to provide specific detail regarding case management services such as how many phone calls or mileage. Provide just a broad estimate of the number of case management hours and costs based on: Estimated Phone hours Estimated personal contact hours Estimated travel time = Total estimated case management time. Calculate time to the nearest hour.
Alternative Care Setting Form
Report Date: March 9, 2018
Re: Joe Smith
File #: 12345
Carrier: American Insurance Co. (No Fault Auto Carrier)
Date of Referral: March 9, 2018
Diagnosis: C4 Tetraplegia, TBI on a ventilator
Summary of Skilled Care Costs:
Daily rate: $675 per day
Sip and Puff Wheel Chair not included: $17,000
Specialty Bed not included: $7,000
Ventilator supplies included with no additional charge
Nursing, physician and therapy included with no additional charge
Case management services: $100 hour. Calculate a charge based on an estimated time to coordinate equipment and services required to transition the client to the skilled care facility
Total Skilled Care Costs:
Alternative Discharge to Home Costs:
For simplification of this assignment, Michigan No Fault coverage was chosen as charges are compensable 100% for 24/7 RN/LPN coverage when determined to be reasonable and necessary. Client is a ventilator dependent quadriplegic with a TBI and would require 24/7 skilled care by an RN/LPN.
Skilled Nursing /RN/LPN 24/7:
Therapy: 30 days of OT, PT, SPL
Sip and Puff W/C: $17,000
Specialty Bed: $7,000
Ventilator Supplies $500 a week
Temporary Ramp at Front door:
Case Management Services: $100 hour. To include arrangement of equipment and services for discharge to home with follow up case management services over the first thirty days.
Total Alternative Discharge to Home Costs:
Total Costs of skilled care:
Total Alternative costs of Home Discharge:
Total savings or costs of Alternative Care:
Case Management Fees for Alternative Care Analysis: $100 per hour. These are billable hours associated with determining the costs of an alternative care setting. Please use the time that it took you to complete this assignment as your billable hours.
Please review the grading rubric for this assignment as it will provide you a guide in preparing you Cost Benefit Analysis. It identifies key areas the assignment will be evaluated, and describes a range of outcomes to evaluate your success.