Centers for Medicare and Medicaid Services (CMS)
RSSArticles
-
A Formal Model Helps Eliminate Duplication, Gaps in Care
Initiatives from CMS make it more important for case management leadership to review the duties, roles, and responsibilities of all disciplines and build an effective model.
-
Vague Job Descriptions Leave Everyone Confused
One of the biggest problems case management consultants encounter is the lack of detailed job descriptions for case managers and social workers. Some hospitals don’t have job descriptions at all, while others use almost the same verbiage for RN case managers and social workers.
-
RN Case Managers, Social Workers Should Work as a Team With Clearly Defined Roles
With increasingly complex patients and changing reimbursement rules, it takes both an RN case manager and a social worker to gather a complete picture of a patient’s situation and create an effective discharge plan.
-
Bundled Approach to Handoff Communication Delivers Significant Safety Dividends
With an estimated 80% of the most serious medical errors linked to communication failures, handoff processes are a rich target for improvement. There are numerous tools designed to help providers remember to convey the most important information when transitioning a patient to another provider, but one approach in particular has demonstrated in multiple studies that it can reduce medical errors and preventable adverse events substantially.
-
Organization Expands Case Management for North Carolina Sickle Cell Population
North Carolina patients with sickle cell disease are a small population that experiences repeated and costly ED visits and hospitalizations. Community Care of North Carolina has 600 care managers statewide, who work primarily with Medicaid patients, matching them with 14 networks and care managers across the state.
-
Orthopedic Nurse Navigator Helps Surgery Patients Stay Healthy
The Comprehensive Care for Joint Replacement program helped the University of Pittsburgh Medical Center Passavant reduce the percentage of total joint replacement patients who are discharged to a skilled nursing facility instead of home.
-
Medicare Payment Codes Related to Care Management
Starting in 2017, the Centers for Medicare & Medicaid Services provided new Healthcare Common Procedure Coding System codes for care management payment.
-
Designers of Collaborative Behavioral Health and Primary Care Models See Growth in Future
Recent Medicare funding for care management services, related to integrated behavioral health and primary care, has provided more incentives for healthcare organizations to use this approach.
-
Secondary Heart Failure Affects Readmissions
Heart failure that develops or worsens during a hospital stay can affect outcomes, costs, and readmissions, so hospitals are advised to identify patients at risk for secondary heart failure.
-
Improved Patient Handoffs Require Comprehensive Approach
Hospitals are paying more attention to patient handoffs as a crucial element in quality and patient safety, with an evolution toward seeing them as not just a distinct task, but more as a comprehensive strategy.