Centers for Medicare and Medicaid Services (CMS)
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Field-based Case Management Program Works with Challenging Patient Population
With a field-based care management program, WellCare Health Plans has reduced hospitalizations, ED use, and readmissions.
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Case Managers Can Learn Best Practices in Leadership Skills
Case managers do their best work when they use leadership skills to keep all stakeholders on track with care coordination.
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Making the Two-Midnight Rule Work for You
The Two-Midnight Rule was introduced by CMS in August 2013. After almost three years, hospitals, case managers, and physicians still struggle with how to implement it while remaining compliant and fiscally sound.
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CMS Backs Off Cuts Due to Two-Midnight Rule
Faced with widespread criticism from the hospital industry and others, CMS proposed dropping the 0.2% reduction in hospital reimbursement due to the Two-Midnight Rule and delayed posting the overall hospital quality star ratings on the Hospital Compare website.
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It’s the Law: Inform Patients about Observation
Beginning Aug. 6, hospitals and critical access hospitals must to provide a written notice and an oral explanation when patients receive observation services for more than 24 hours.
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The Sooner Patients Receive Palliative Care, the Better the Outcomes
When medical providers address the stress and other suffering patients are experiencing along with their medical needs, patients tend to do much better. That’s where palliative care can be an valuable adjunct to medical treatment.
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When Patients are Stressed, in Pain, Suggest Palliative Care
Case managers are in a good position to recognize patients who have serious medical problems that are causing them and their family members stress, and refer them for a palliative care consultation, experts say.
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When Questions Arise, Physician Advisors Are There with the Answers
DCH Health System’s seven part-time physician advisors perform a variety of tasks to help ensure that the hospitals are appropriately reimbursed and that patients move smoothly through the continuum of care.
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Who Makes a Good Physician Advisor and What Can They Do For You?
A physician advisor can be invaluable if the hospital chooses the right person for the role.
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Make Your Physician Advisor Your Closest Ally
As the pressure increases for case managers to help ensure that hospitals comply with payer requirements and get paid appropriately, physician advisors can be a valuable ally.