Centers for Medicare and Medicaid Services (CMS)
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Hospital Collaborates With EMS to Bring Case Management to Homes
An Ohio hospital’s population included people with lower income, less education, and many health challenges. Case management could help once these people entered the hospital, but the challenge was to prevent the problems that first led to ED visits and rehospitalizations.
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‘Person-Centered’ vs. ‘Patient-Centered’ Care
Long-term support services should provide “person-centered care,” according to a 2014 rule from CMS. In everyday patient care, this translates into a focus on learning a patient’s wants and needs, which helps the case manager align treatment with the patient’s desires.
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Value-Based Care: Tips for Case Managers
Hospitals are struggling to meet the goals of value-based payment models. Value-based models are designed to improve outcomes, such as quality of care, satisfaction, and complications, while reducing costs. The impetus comes from CMS, which has set quality and efficiency standards for hospitals.
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To Build a Case Management Team, Focus on Engagement
There is not one specific way to improve case management and develop the best teams. But a good first step is to identify team members and to focus on the correlation between their skill sets, engagement, and outcomes.
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Government Moving to More Risk Arrangements Based on Quality
The Center for Medicare & Medicaid Innovation wants 100% of providers in upside/downside by 2025 and is using the Bundled Payments for Care Improvement Advanced model, primary care models, and (increasingly) more mandatory models to get there.
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Ethical Issues and Standards in Case Management, Part 2
In October, we began our discussion on ethical issues of relevance to case management professionals. The principles should provide case managers with a framework when dealing with the tensions between providing quality healthcare and containing costs. However, it is doubtful that the tension can be overcome completely. Even when payers or health insurance plans make legitimate decisions, healthcare professionals may sometimes find that they cannot support these decisions in good conscience. How you respond to these dilemmas is significant in terms of maintaining ethical integrity.
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Medicare Now Covers Nonskilled Home Care
Typically, when discharge planning involves the need for home care assistance, case managers rely on the patient’s family and friends to assist with activities of daily living. In many families, this can work just fine. But where there are odd family dynamics or if a family member is not equipped to be a caregiver, there is a need for outside help.
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CMS 2020 Final Rules: Discharge Planning Revisions Released
New rules intended to help empower patients preparing to move from acute care into post-acute care will soon govern hospital discharge planning, according to the Centers for Medicare & Medicaid Services.
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Hospital Gives Patients Tips on Finding the Right Skilled Nursing Facility
When hospitalized patients need to be transitioned to a skilled nursing facility, one of the first hurdles is finding the right place. Spaulding Rehabilitation Hospital in Boston has developed a one-page tool to help families with this decision.
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Transitioning Patients to Skilled Nursing Facilities Is Challenging
Too often, patient information is lost or inadequate during transitions from hospital to skilled nursing facilities. This causes challenges that case managers can help overcome.