Centers for Medicare and Medicaid Services (CMS)
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Here’s How Care Management and Care Coordination Work in NY
Typically, referrals to New York’s health home program are made by doctors, probation officers, or mental health clinics, although they could be made by any community organization or provider.
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Across New York, Organizations are Redefining Best Practices in Care Management
All across the Empire State, healthcare payers, providers, and community-based organizations have spent several years participating in a grand, national experiment of improving medical care for the highest-risk Medicaid enrollees.
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Is Your Case Management Department Making the Grade?
As a case manager or an administrator of a case management program in your organization, you may be called on to participate in the evaluation of the case management model, its effects on the organization, or its effects on patient outcomes.
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Get Ready to Give Your Patients the MOON
Hospitals should start now to develop a process to deliver the Medicare Outpatient Observation Notice (MOON), alerting patients that they are receiving observation services and informing them of their potential financial responsibilities.
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As Healthcare Becomes Value-based, Hospital Partners With the Community for Patient Care
Spartanburg (SC) Regional Healthcare System is partnering with providers at other levels of care and in the community to improve care for Medicaid patients and the uninsured.
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Community Partnership Provides Home Visits for At-risk Population
Rockdale Medical Center in suburban Atlanta teamed up with community partners on an initiative that has reduced readmissions and ED visits by high-risk, medically underserved patients.
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Turn that Little Black Book into a Comprehensive Database
With payers’ increasing emphasis on costs over the entire episode of care, case managers need to expand their address books to add resources throughout the community.
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Start Now to Identify Gaps in Transitions Before the Hospital is at Risk
Even if your hospital has little or no financial risk for what happens to patients after treatment in an acute care setting, case managers should connect with community organizations that provide the types of resources your patients need.
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Going ‘Beyond the Hospital Walls’ May Be Further than You Thought
With new initiatives that put hospitals at risk for what happens to patients for as long as 90 days after discharge, case managers need to look at resources in the community when creating a discharge plan.
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Mann-Grandstaff VA Medical Center’s Insulin Adjustment Protocol
Nurses at Mann-Grandstaff VA Medical Center of Spokane, WA, shared their insulin adjustment protocol for RN case managers with Case Management Advisor.