(New start time)
(New start time)
Welcome and Opening Remarks, Partha Mishra, President, Optum Global Solutions; Mark Leenay, MS, MD, Chief Medical Officer, Optum International; Heidi Leenay, Vice President, OptumHealth Education
Medicare—What Clinicians Need to Know, Mark Leenay, MS, MD
Medicare provides coverage for more than 50 million Americans, including adults over the age of 65, and younger individuals living with permanent disabilities. Uncovered health care expenses and becoming ill are among the highest concerns cited by middle-income baby boomers. Most boomers who are within a few years of turning 65 do not understand what their health insurance benefits will be for doctor visits or hospitalization once on Medicare, and having a good understanding of how the program works is an important step in alleviating the confusion associated with the transition to Medicare. Working with Medicare-eligible individuals includes helping them understand their benefits under their Medicare plan. The purpose of this presentation is to enable the learner to understand eligibility, coverage options, premiums, and enrollment options for Medicare Parts A, B, C, and D, as well as Medicare supplement insurance plans.
- Define and understand eligibility, coverage options, premiums, and enrollment options for Medicare Parts A and B.
- Define and understand eligibility, coverage options, premiums, and enrollment options for Medicare Part C, Medicare Part D, and Medicare supplement insurance plans.
- List the steps a patient must take when a drug plan denies coverage of a prescribed medication.
The Impact of Evidence-Based Medicine (EBM) Guidelines in Health Care, Bernie E. Elliott, MD
EBM guidelines are playing an increasingly prominent role and have become well accepted in the U.S. health care system. With its foundation in the peer-reviewed medical literature, EBM guidelines support the delivery of quality and efficient health care across the care continuum by promoting a standardized approach to clinical decision-making and care planning. By supporting the “right care” at the “right time” and “right place,” EBM guidelines ensure improved outcomes and resource utilization while providing a common foundation to facilitate conversations among key stakeholders, including providers and payers. With a focus on MCG, this presentation will provide an overview of EBM guidelines and their role in care management to drive quality and effective care.
- Provide an overview of EBM guidelines and the role they play in improving the delivery of health care.
- State the impact of EBM guidelines on providing quality and efficient medical care.
The Use of EBM to Facilitate Care Progression, Bernie E. Elliott, MD
This presentation will focus on the application of EBM guidelines. Case vignettes will be incorporated into the session, to offer a practical understanding of how EBM and MCG are utilized to support the delivery of optimal medical care.
Adherence to EBM guidelines varies widely, and some physicians have concerns that such guidelines characterize a rigid or oversimplified practice of medicine. Factors that contribute to physician nonadherence to EBM guidelines, and methods that may be used to guide more appropriate care will also be presented.
- Explain how EBM guidelines can be applied to facilitate quality and effective care.
- Through the use of case vignettes, provide an explanation of how EBM and MCG are utilized to support the delivery of optimal medical care.
- Describe factors that contribute to physician nonadherence to guidelines and potential ways to overcome these barriers.
Applying Heart Failure (HF) Treatment Guidelines to Nursing, Lecia Snell, MSN, APRN-CNS, CCTN
HF has reached epidemic proportions in the United States resulting in increased morbidity, mortality and health care costs. Nurses have a significant impact on the care of these patients effecting both outcomes and quality of life. The 2013 American College of Cardiology Foundation/American Heart Association (ACCF/AHA) Heart Failure treatment guidelines are a research-based model of management for each stage of HF. This presentation will review these guidelines throughout each stage of HF and assess the implications to nursing.
- Describe the clinical presenation and diagnosis of heart failure.
- Provide an overview of the ACCF/AHA HF treatment guidelines throughout each stage of HF and review the implications to nursing.
Dinner (provided)—Exhibits open
Coordinating Care Using Transitional Strategies, Lecia Snell, MSN, APRN-CNS, CCTN
Hospital readmissions can lead to poor patient outcomes, increased costs and financial penalties to hospitalizations. Nurses are at the center of care coordination to help reduce these potential preventable hospitalizations. Transitional care management has become the core of coordination for patients moving between care venues. Using a case study scenario, this presentation will describe evidence-based transitional care strategies and resources to help the nurse apply to their practice and build a strong foundation for care coordination.
- Identify evidence-based transitional care strategies to coordinate care and prevent hospital readmissions.
- Examine strategies to reduce readmissions and improve patient outcomes including transitional care and postdischarge follow-up.
Palliative Care and Its Impact on Patient Outcomes, Mark Leenay, MS, MD
For patients hospitalized with serious illnesses and their families, the goal of palliative care is to provide critical support by providing information about prognosis, ensuring that symptoms are managed, helping to clarify goals of care, and addressing psychosocial and spiritual concerns. The palliative care paradigm uses a multidisciplinary approach to provide palliative care to relieve and prevent the suffering of patients throughout the continuum of an illness. Palliative care can be offered to patients at any time between diagnosis and recovery.
Once patients are discharged, many hospital-based palliative care teams cannot continue to play active roles in patient care. It has been suggested that understanding the prognosis, being prepared to manage symptoms and knowing whom to call with questions would help families cope more effectively with the challenges of life-threatening illness.
During this session, Dr. Leenay will explain how palliative care offers support for both patients and their families, how to improve the quality of life for persons suffering from serious illness, the impact on clinical outcomes, and medical costs and tools that can be used to help patients with the discharge transition from hospital.
- Identify specific hospitalization rates related to palliative care.
- Assess the impact of palliative care on clinical outcomes and medical costs.
- Describe the effects of palliative care on patient and caregiver outcomes.
- State new and old paradigms for palliative care.
- Explain the tools that can be used to help patients and families transition from the hospital setting.
UnitedHealth Group’s Center for Nursing Advancement: Creating Healthy Work Environments Where Nurses Grow, Succeed and Thrive, Dawn Bazarko, DNP, MPH, RN, Certified Mindfulness Facilitator; Senior Vice President, Center for Nursing Advancement and Founder of Moment Health, UnitedHealth Group
This session is not accredited.