Case managers utilize RPathFinders to conduct problem-level assessments and re-assessments. The RPathFinders
constitute the "building blocks" that construct a customized Plan of Care for each member. This approach
offers the case manager the maximum flexibility to develop a Plan of Care that encompasses either a single diagnosis
or co-morbid condition(s) and enables them to individually rate their problems according to best practice guidelines.
Then, using these problem-specific RPathFinders, the Case Managers identify the Member's overall status with regard
to their clinical Status, Knowledge, and Behavior during the case management process and, relate them to the interventions
and both long and short-term goals set by the Case Manager.
Accreditation
CareAdvantage acknowledges health plans' needs to meet various accreditation standards, especially those of AAHA-URAC, which is viewed by the market place as a hallmark of care management excellence. The RightPath™ methodology has been constructed to address the mandated elements of process and structure that include:
- Collaboration between the Case Manager, Provider and Member in the Plan of Care with the establishment of Anticipated Case Results and a Global Goal for each member
- Full disclosure of the case management process with corresponding member consent, since membership is voluntary
- Identification of barriers to the Plan of Care
- Establishment of long and short-term goals linked to member's problems
- Selection of interventions that are most likely to help the patient attain identified goals
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