WOW! That's a lot of snow!

In Florida it's huricanes, in California - wildfires, in Atlanta - flooding. It seems that Mother Nature has a little something special in store for you no matter what part of the world you're in. Here in Ohio, it's snow....and boy, oh boy, we've had a lot of it the last few days! I'm sure that most of you have seen the news about the debilitating snow - it's even shut down the Federal Government! How, then, you might ask, does AIMM ensure that services continue, despite Mother Nature's attempts to foul things up? Well, it's a very good question, and you might be surprised to know that you're not the only one curious for the answer - URAC, our accrediting agency, gets pretty interested too! Ensuring that AIMM has a solid "Disaster Recovery Plan" is a part of what URAC looks at when we go through the accreditation process.

First, let me say, that AIMM isn't concerned just about snow - we've got plans for it all - starting with the most simple "disaster" scenario like a computer malfunction, all the way up to the most catastrophic scenario like the office building burning down and all our equipment being lost!

Second, I would point out that we're all a bunch of "old ER & ICU nurses" (not old in terms of age, just in terms of experience :-)...we're really all truly young, pretty, etc :-) ) We're a pretty tenacious and resilient bunch. We know that people get sick even when the weather is bad - sometimes it even feels like people are more likely to be sick when the weather's bad. All in all, we're pretty used to working through any adverse conditions - and neither snow, nor rain, nor heat, nor gloom of night, nor the winds of change... (well, when a slogan's good, you've just got to adopt it, right?!) And, fortunate for us, we use only RNs (old ER & ICU RNs - old enough to remember the days of charting on - dare I say it - charting on paper with a pencil (gasp!!!) - if worse came to worse we'd break out the papyrus and graphite...whatever it takes to get the job done and the patient taken care of!).

Thirdly, we are an extremely techno-savvy organization. We LOVE technology, and if you've gotten to know us at all, you've probably seen firsthand that we're "all over" the computer stuff....every piece of equipment in our organization is the latest, greatest, most nimble, and most user-friendly, piece of technology on the market. (It helps that our COO is a techie/geek :-) ) I am able to control every aspect of our operation remotely. Need a phone system change, or a routing change made on the fly - no problem! Need a key piece of information, call me. It doeesn't matter if I'm in Timbukto or the office. I can get you what you need, and I can do it quickly!

Fourth, we've got back-ups for our back-ups! We back up our data in multiple different ways...some of those are immediate backups, some are hourly, some are nightly. We've got the main server in the office, and we've got TWO back-up servers. If the building burned down and "everything" was lost, we still wouldn't have lost everything - we've got servers and computers stored offsite! All we'd have to do is load the backup data onto one of the spare servers, and we'd be live in a matter of minutes!

Fifth, we test, and test, and re-test, and on and on and on! We try to break the system. We're constantly challenging the technology to make sure that it isn't going to fail us.

Those are just the "highlights" that I have room to describe here - there's even more! AND YES - it's all 100% secure, encrypted, HIPAA compliant, etc....

So, as one of my favorite Christmas carols says...let it snow, let it snow, let it snow!

Top 5 reasons you want AIMM to do your Cancer Case Management

Well, it was another fine "Fireside Chat" for the AIMM staff this past weekend. One of the topics we covered was Chemotherapy. Of course, I don't want to give away all our "secrets", but I thought this might be an appropriate forum to share some key things that AIMM does differently than other medical management vendors when handling cancer cases:
1 - AIMM uses only RNs (and MDs too, but never laypeople, never LPNs, etc...)....recently a new client joined us, and the previous medical management vendor had an LPN handling Case Management on a cancer patient. I'm not entirely certain that it was just the fact that the Case Manager was an LPN, but I feel pretty sure that her being an LPN certainly contributed to her handling of the case (and the fact that she didn't recognize that the plan of treatment was worthy of aggressive questioning / experimental / not a covered benefit).
2 - AIMM investigates the following on every chemotherapy agent: Name of the drug being utilized, route/administration method, dosage, for the treatment of what specific type of cancer, and at what billed cost. We also investigate FDA approval status of the medication (as it is being used (dose, route, single/combo agent, etc), and for the condition it is being used to treat).
3 - AIMM investigates & communicates with patients and providers about whether there specific plan design considerations/constraints - For Example: what if there are no FDA approved drugs for this type of cancer (because it's a rare type, as an example)? What if this is an "off label" use of an FDA approved medication? What if this is a clinical trial? We feel strongly that patients deserve to have all the facts up front - cancer is devastating enough...they don't need any payment surprises happening 3 to 12 months from now!
4 - AIMM uses a variety of methods to ensure that the billed costs coupled with any applicable discounting (aka PPO discounts) results in the cost of the medication being reasonable (close to AWP).
5 - AIMM ensures that the patient has every possible resource at their disposal, including facilitating use of community resources, obtaining case reviews from experts, accessing governmental (and other) financial assistance, and providing an enormous amount of both verbal and written education items.
6 - AIMM ensures that contact happens with the patient - we never close a cancer case simply because we can not reach the person by phone - instead we will seek out assistance from the designated plan representative to assist us in connecting with the patient. (We once discovered an identify theft situation because of this - our patient's identity had been stolen, and was being used by someone else who was seeking cancer treatment. Had we not gotten the plan representative to assist us in connecting with the member (the member had ignored out telephonic outreach to her because she was healthy and didn't feel she needed us), we (and she) would never have known that the person getting cancer treatment wasn't really her! Her lifetime maximum would have been used up by an identity thief!

These are just a few of the ways that AIMM is "special" when it comes to handling Cancer and Chemotherapy cases. If you would like more information, please feel free to contact me! (I'm sure you noticed that there are 6 reasons, when the title says "5 reasons"....that's because AIMM always strives to give you more than you expected, and to "under promise over deliver" - not just in Cancer Case Management, but in everything we do.)

PS - Nurse Kelli was the presenter for the chemotherapy fireside chat. It was her first time doing a presentation like this. She did an AWESOME job, we all learned a lot :-)

I'll answer to anything....

A funny thing happened yesterday....
Nurse Belinda retrieved a very garbled voice mail message...she was able to barely make out the phone number to return the call, and thought that the caller had said his name was Andy. Well, she called Andy back, and said "May I speak with Andy please?". The man who answered the phone said something that essentially conveyed he was Andy. She explained who she was and that she was returning his call, and inquired about how she could help him. He said he was responding to one of our outreach calls, and she searched in vain to try and find a record for Andy so that she could see what we wanted to talk with him about. After a few seconds of searching she asked him to spell his name and he responded "T O M"....Well, needless to say she was a little bit flustered by this...she asked "then why'd you say yes you were Andy?" He got the better of her, though, because his reply was "Well, I'll answer to anything when a pretty girl is calling". We all LOVED this little anecdote, and thought you might enjoy it too. We thought it was a good example of what we mean when we talk about "building a rapport with our patients"...a little humor goes a long way :-)

By the way - this is Nurse Belinda (she's one of our newer nurses), and she is a pretty girl.

Preparing for this week's "Fireside Chat"

Want to know another thing that makes AIMM special? Did you know that the AIMM staff gather together once a week via Webinar (usually Saturday mornings) and spend time focusing on a single medical management topic? We began doing this recently as a part of our 2010 "New Year's Resolution". So far, everyone has loved it, and we've even opened it up now to key industry partners (brokers, consultants, etc...). So far we have covered the following topics:

• Stop Loss - the who, what, when, where, why, and how
• Behavioral Health Precertifications
• Transitions between levels of care
• Basic AIMM Sales Presentations - what clients hear & expect, and what make AIMM special in the market-place

This week we are covering the topics of:

• Chemotherapy
• Dialysis

Nurse Kelli, the VP of Care Management is presenting the chemotherapy course. I am presenting the dialysis course. In preparation for my portion I am doing some research, and I came across this great article that shows empirically some of the things that we in medical management have strongly suspected for a long time: PRINCIPAL FINDINGS: The study results show that patients in for-profit dialysis facilities tend to receive significantly lower quality of care (average quality score: 0.7588) than those in not-for-profit (0.8764) or government-owned facilities (0.8283) (p<0.05).>

I share this with you because I wonder how many medical management company's invest time ensuring that all their staff are up to speed on these kinds of issues?

Of course, as a part of our dialysis training we will also be talking about renal repricing and other new laws/programs that ensure cost-effectiveness.

If you're interested in joining us, let me know!

Deb