What teams? PHC? Cm? Hcmss?
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You can try to convince yourself you're safe but we have been told teams will be cut in half. Even cutting all CHEs won't get you close
That would fit with the rumor that LTIH is being cut in half. LTIH woild come to HCM as HS
They are hoping we have a large enrollment for 2018. I wouldn't bet any money on it
HCM here. We were told that more HCMs were being added in January because there was going to be a huge increase in HS members then.
Don't be delusional. No one is safe.
HCM RN here. Focus for us is to contact how many you can in your work day and update surveys prior to moving them to monitored. We were never told to ignore HEDIS surveys because they are a big focus in our world right now. Keep in mind that closing all care plans prior to moving to monitored status is what is so time consuming. I do feel bad for the PHCs, you are not catching any breaks! I am also sad to hear that the HCM SS' tasks are dwindling. I depend on your expertise and know that you do so much for the members.
PUa0cQv-1hpd, I'm an hcmss and we are still being told quality measures, hit metrics, etc....since PHC and hcmss are starting care planning soon, and we're being told to keep on keeping on and the CMS are being told otherwise, it seems they are on the chopping block? Maybe they're on,y keeping enough CMs for the ones that are medically needy? With the behavioral health pillar they spoke off, hcmss care planning, warm transfers and the fact queues tend to dip at this time and pick up again in January, it seems hcmss and PHC are in a better position than CMs? As another poster said, the more they move folk off their rosters, the less of a work load or job they have
Phc here ...we are still told 10 a day and not to focus on HEDIS or mDAT unless overdue. If we have a UTC and a choice of monitored or RIT send to monitored. Humana has no uniformity!
This is what happens when leadership and communication are lacking. Nobody is on the same page.
We are being told NOT to move so many members to monitored, only chronic UTC and members that we just simply aren't doing anything for at all. Then we are being told we can bring them back at any time from monitored. Our coach is basically saying if there isn't absolute justification don't use it
I agree that is not good. 😔
I hope you're right, but no way SSs can remain at 220 with no tasks. And that is where we will be by next week. Warm transfers wouldnt even get us all 1 call/day. As much as I wish they would keep me to work with 1 member/day, I'm preparing for the worst. Maybe they will reduce to restricted or clinical licensure? Really no way to know until DDay. Below HCM posted s/he was told to take as much time as needed to move everyone to monitored. But what happens then?? No members=no job.
It makes me nervous that PHC’s are still being pushed hard for 10 contacts a day, and not getting clarification on what the long term goal is, like the HCM seem to be getting.
We are still focused on metrics with no discussion of where we are heading or what the big picture looks like. Just get 10 a day. Graduate to monitored yes, but keep contacts up. We will be adding care plans to our documentation, but no other indication of what’s to come.
Makes me wonder if we simply won’t be part of the big picture, longer term 2.0 goal.
That has to do with closing out the cases efficiently and not having open ones out there by hcmss. Given restricted states, licenses needed and the social service needs of the higher acuity member and the skill sets needed, I don't see hcmss going anywhere
HCMRN and I was also told that metrics/peer average were no longer going to be considered. My team was asked to spend as much time needed with each member, make all the support calls needed to help the member and then change them to monitored as soon as possible. The goal is to move all members to monitored. This has been repeated several times by my coach. It was my understanding that talk time wasn't being looked at either.
HCM SS still have warm transfers. Tasks are less due to graduation
I have. We were told to focus on member needs and not worry about numbers. Our coach told us going forward we would be evaluated on a combination of things, MPS quality, audit scores, talk time, etc. But not metrics. I'm a HCM role
I haven’t been told “no metrics” either.
No mectrics? I have not heard that.
Pretty sure HCMSS tasks will continue to get lower. The HCMs are being encouraged to take care of member issues ourselves now, where before we were told to "not make extra work for ourselves" and task HCMSS for everything that came up. Now it's a push for actual case management and telling us we take care of member issues if possible. Couple that with all HCM making less calls overall now that there is no metric, I don't think HCMSS will have much work to do at all going forward
HCMSS here. We are losing tasks daily with 400 tasks for 220 SSs at COB today. Unless something changes, we'll be out of things to do by then so I'd say 11/1 or sooner.
Maybe coach 22 or 💯 can tell us if they feel safe enough to let that info out