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Centers for Medicare and Medicaid Services (CMS)

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  • Patients with Parkinson’s Disease Often Lost to Follow-Up Care

    Telehealth visits can improve continuity of care, quality of life, and overall health for patients with Parkinson’s disease, recent research shows. Although Parkinson’s affects 1.2 million people in the United States, there is little research on people in later stages of the disease.

  • Detailed Resource Tools for Care Coordinators and Case Managers

    Case managers and care coordinators need such a wide range of knowledge about community resources to address their patients’ social determinants of health that resource tools can be a huge time-saver. For a care coordination program involving complex pediatric patients, leaders developed a series of nearly two dozen resource guides they call playbooks.

  • Inside the Indiana Complex Care Coordination Collaborative

    Indiana’s Medicaid program administrators found value in embedding nurse care coordinators in primary care practices to address social determinants of health and transitional care issues in a population of children with complex medical issues.

  • Indiana Medicaid Officials Embrace Care Coordination Project

    A project to improve care coordination for children with complex medical needs revealed well-trained nurse care coordinators could manage a 100-patient caseload and improve outcomes. Nurse care coordinators were embedded in primary care provider offices and were trained to provide care coordination, including helping patients with medical and social needs.

  • Better Care Communication Needed for Home Health

    Researchers wanted to know if there is an association between home health and gaps in care coordination among providers. They found patients receiving home healthcare are sicker, experienced more functional dependencies, and reported more preventable drug-drug interactions. While home health was not associated with a difference in gaps of care coordination, it was associated with twice the risk of a preventable adverse outcome.

  • Many Safety Net, Rural Hospitals Do Not Properly Address Social Needs

    Safety net hospitals, critical care hospitals, and rural hospitals often do less than needed to address the social determinants of health of their vulnerable populations, particularly during the COVID-19 pandemic, new research shows.

  • The Role of Critical Access Hospitals

    In rural areas, critical access hospitals provide care to patients who otherwise would have to travel much further for adequate care. Serving in a critical access hospital can be a much different experience than a larger hospital system, or even a hospital in an urban or suburban environment. Due to lack of training and support, even the case management process might not be as seamless or efficient as it is in other settings.

  • Understanding Bundled Payments

    Bundled payments can be confusing for case managers to navigate. The philosophy behind the bundled payment reimbursement model is that in managing the patient carefully across the continuum, transitions will be smoother and the care will improve, all while staying mindful of how the dollars are spent. It is meant to be a meeting of quality of care and cost-effectiveness.

  • Best Practices for Maternity Case Management

    In many ways, case management in the maternity and labor/delivery units is unlike other areas of the hospital. Often, the mothers and babies are healthy, and simply in need of support through the process. For that reason, it may even seem that case management is unnecessary. However, it is important to maintain a strong case management department that serves in labor and delivery as well as the postpartum units.

  • Case Managers Can Better Educate Patients and Families About Opioid Addiction

    While the world focused on the COVID-19 pandemic, another crisis — the opioid epidemic — continued to unfold, taking hundreds of thousands of lives. Hospital discharge is an opportunity for case managers and other providers to help prevent patients from becoming victims of opioid overdoses.