Centers for Medicare and Medicaid Services (CMS)
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ACO’s Comprehensive Patient Navigation Can Reduce Costs, Increase Satisfaction
Surprisingly, accountable care organization enrollees who are given fewer choices but better navigation assistance in making decisions are happier with their healthcare access, researchers found.
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Intensive Care Management Works with Complex Medicaid Population
One way to reduce costs among a population of high-cost, high-utilization Medicaid patients is to use intensive care management. In a study of an intervention involving a nonprofit organization that provides integrated care to complex patients, investigators found a reduction of more than $1,900 in total medical expense per member per month.
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Possible Solutions to Poor Interhospital Transfers
Interhospital transfers can be frustrating to nurses and lead to worse outcomes for patients, research shows. But hospitals can take steps to improve the process and reduce risks for patients. The first step is to eliminate unnecessary transfers.
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Better Care Coordination Needed for Interhospital Transfers
Interhospital transfers can be challenging and frustrating for nursing staff — and sometimes dangerous and tragic for patients and their families. Health systems should pay more attention to how these transfers are handled and work to improve communication between sending and receiving hospitals.
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Primary Care Is on Life Support, But Case Management Could Be Antidote
Primary care is facing decline due to financial factors and clinician burnout. One solution is to assign case managers or care coordinators to primary care offices to improve communication between primary care providers, hospitals, and other healthcare entities.
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States: End HCW COVID-19 Vaccine Mandates
Twenty-two states have joined to petition CMS to stop mandating COVID-19 vaccines for healthcare workers. In a Nov. 18, 2022, letter to HHS Secretary Xavier Becerra, West Virginia Attorney General Patrick Morrisey called for the vaccination requirement to be withdrawn.
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Care Managers Help Improve Birth Outcomes with Prenatal Coordination
Recent research shows a prenatal care initiative, called Strong Start for Mothers and Newborns, can produce positive health results. The program works with Medicaid beneficiaries in more than 30 states through maternity care homes.
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Build a Healthy Relationship with Insurance Providers
It can be a tense relationship. Healthcare systems and providers — including case managers — have admitted it sometimes feels like insurance is the enemy, and patients have been known to carry that same sentiment. How should case managers and other healthcare professionals work out a healthy connection with insurance companies, and even work to strengthen that connection to help build a more positive view of the relationship among healthcare, insurance, and the patient?
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Better Recruitment Can Improve Safety During Staff Shortages
As staff shortages threaten patient safety, hospitals and health systems are eager to bring more clinicians on board. But this is becoming harder, especially for the most desired candidates. Improving the application and hiring process can improve patient safety.
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Updates to CMS Outpatient Rules
In July, CMS issued proposed rules that could raise Medicare Outpatient Prospective Payment System rates in 2023.