The powerful data analytic tools used for predicting patients at risk for high healthcare utilization, healthcare costs, and mortality are essential to a successful population health model of care.
A case manager works on a postacute transfer plan for a patient who is critically ill with sepsis and at risk for acute renal failure. Because the patient has a history of IV drug use, it is likely that long-term acute care hospitals will deny him admission.
Many case management directors have questions that arise from time to time on a variety of topics. Here are two such questions along with responses that may help if you’re facing similar challenges.
Q: Sometimes a patient doesn’t understand his or her conditions enough to do what he or she can to prevent readmission. Any tips on what a case manager can do to empower patients to learn about their health?
Data is an essential tool in understanding the patient population that will guide the focus of your case management program, and both internal metrics and community/public health data will provide strategic focus to case management practices.
A proposed change to CMS’ 2019 Physician Fee Schedule proposed rule is causing controversy. CMS is suggesting revisions to the fee schedule aimed at simplifying the way physicians choose codes.
The U.S. Senate passed its amendment to H.R. 6, the Opioid Crisis Response Act of 2018, on Monday in a 99-1 vote to address the United States’ ongoing opioid addiction epidemic.
If your organization is part of a Medicare accountable care organization (ACO), changes may be on the horizon. CMS is proposing changes to the program that would require organizations to take on more financial risk and is giving it a new name, “Pathways to Success.”
