Starting a population health program can not only help organizations improve patient health, but can also help a hospital's bottom line by reducing readmissions and cutting down on costly emergency department visits. But many case managers may wonder what it takes to get a population health program off the ground.
The 2-midnight rule may get a little tweak if the proposals in CMS' 2016 OPPS proposed rule comes to fruition. The rule proposes that physicians now be granted a little more flexibility when it comes to ordering inpatient admissions, even when the stay is expected to be less than two midnights?provided of course that the stay is justifiable from a medical standpoint and the physician clearly documents his or her thinking on the case.
Your success as a case manager often depends on how well you work with others in your organization. At any organization, ensuring high-quality patient care, accurate documentation, and regulatory compliance takes a team effort.
Technology is everywhere, including hospitals and doctor's offices. Studies have found that in some cases technology can be an asset to patient management, with remote monitoring showing promise in helping to reduce readmissions.
Case management in Alaska isn't for the faint of heart, according to Randi Ferrare, RN, BSN, interim director of case management and social work at Providence Alaska Medical Center. Some of the challenges force case managers at Providence Alaska to work a little harder and get a little more creative to meet the needs of its patient population. One innovative program at the hospital is its case management educator position.
When the placement agency called and said it was looking for an interim case management director in Alaska, and asked if she was interested, Randi Ferrare, RN, BSN, hesitated for just a moment.
At many hospitals the terms Utilization Management (UM) and Utilization Review (UR) are used interchangeably. Are they the same thing? No, they're not, according to Stefani Daniels, RN, MSNA, ACM, CMAC, and Ronald L. Hirsch, MD, FACP, CHCQM.
Many hospitals have added case managers to their EDs, but these case managers face unique situations. CMM experts answer questions about how to handle these issues.
More and more hospitals are choosing to become part of Accountable Care Organizations (ACO) in an effort to streamline patient care and reduce costs. If your organization is considering joining an ACO, you may have questions about how these groups work and how the change might affect your job. CMM asked several experts for the lowdown on what the transition to an ACO might mean for case managers.
