Centers for Medicare and Medicaid Services (CMS)
RSSArticles
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Patient Pool Eligible for Lung Cancer Screening Expands Under Amended Criteria
CMS lowers age, smoking history thresholds.
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Loneliness and Social Disconnection Common During COVID-19 Pandemic
More than one-third of Medicare beneficiaries said they were more socially disconnected, and nearly one in four reported they were lonelier during the COVID-19 pandemic, according to the results of a recent survey. -
Changes in Senior Care Post-COVID-19
Although the COVID-19 pandemic is not over, it is not too early to see changes to senior care because of what was learned in 2020 and beyond. -
CMS Requires COVID-19 Vaccinations for Healthcare Workers
The Centers for Medicare & Medicaid Services’ highly anticipated interim final rule requiring healthcare workers to be vaccinated against COVID-19 will bring new obligations for healthcare employers, but it also might help overcome the objections of some employees.
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Case Management at the Entry Points: Ensuring Reimbursement Through Appropriate Surveillance
At a time when capacity and reimbursement are more important than ever, case managers play a key role in helping operations run smoothly. One way this happens is through monitoring the entry points of the hospital. These points include the emergency department, post-anesthesia care unit, direct admission to the units, or transfers from other facilities. This is not to say case managers should now add “security guard” to their extensive list of roles and tasks; rather, they are uniquely positioned to survey the whole picture, including how entry points are used. -
Hospitals in States Without Medicaid Expansion Face Discharge Challenges
States that have expanded Medicaid under the Affordable Care Act reported fewer hospitalizations for uninsured acute ischemic stroke patients than states that did not expand Medicaid. -
CMS to Issue Rule Mandating Vaccines for Healthcare Workers
President Biden has dropped the carrot and picked up a stick, ordering healthcare workers — all 17 million — to receive the COVID-19 vaccine, or Medicare money may be withheld from their employers. -
Best Practices for Managing Denials
When denials occur, case managers should create a plan to investigate and manage each one to determine why the claim was denied and how they can help. Using this approach, some managers have uncovered trends and root causes that can prevent future denials. It is critical for case managers to hone this skill for the benefit of the patient and the hospital. -
A Hospital at Home Program and the Role of the Care Management Team
For many healthcare systems, a hospital at home program was a necessity born out of COVID-19. At Indiana University Health, a program that allowed patients to continue treatment and recovery at home after discharge had been discussed before the pandemic, but never put into action. That changed when the pandemic started. They went forward with the program, knowing it was the right time to try it. -
How to Help Patients with Limited English Proficiency
As with many other unfunded federal mandates, interpretation services in hospitals face a variety of resource challenges, including insufficient staff training, too few interpreters, and cumbersome technological solutions. To surmount communication barriers, case managers and other healthcare professionals should pay attention to language access, such as interpreters and translations, usable health information (which is eliminating medical jargon), and cultural humility.