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As the United States becomes more diverse, healthcare facilities treat more patients with limited English proficiency. This highlights the need for more effective interpreter services, especially at discharge. Care coordination and transitions could improve if health systems provide more consistent and adequate interpretation help to patients with limited English proficiency, research shows.
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A government billing records audit will make most hospital leaders nervous because of the potential financial — and even criminal — consequences, but understanding the process and best practices can alleviate the stress.
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For decades, risk managers have tried to improve safety by encouraging patients and family members to speak up when they are concerned about care or suspect something might be wrong. Some progress has been made, but recent data suggest one group remains reluctant to speak up: the parents of pediatric patients.
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As U.S. healthcare providers shift to value-based care, they need to keep up with various governmental funding plans that could increase options for patients. For example, some states create opportunities for dual-eligible beneficiaries to join Medicare Advantage Dual-Eligible Special Needs Plans and Medicaid plans operated by the same insurer. Researchers suggest these plans can decrease inpatient admissions and nursing home admissions.
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The results of a new study suggest Medicare spending on healthcare in its Bundled Payment Program could be improved by calculating target prices as accurately as possible. Case management and other resources could become more effective and efficient.
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CMS explains the new 2021 methodology for its Hospital Quality Star Ratings uses “a simple average of measure scores to calculate measure group scores and Z-score standardization to standardize measure group scores” in five measure groups.
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Hospital leaders had criticized previous ratings because they believed the methodology used to create them was flawed and produced inconsistent results that made the ratings misleading and not useful to consumers.
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The Patient Activation Measure can help case managers discover how engaged patients are with their care and what types of services and assistance they may need.
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As case managers work harder to meet their organizations’ patient engagement goals — particularly in the value-based care model — evidence-based tools can help them succeed. One such tool is the Patient Activation Measure, a scale that describes four stages of activation. Research showed the tool to be a valid and reliable instrument to measure activation and to help patients individualize care plans.
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Social workers play a vital role on the interdisciplinary care team across the continuum of care. Working in concert with RN case managers and other members of the healthcare team, they assist in guiding and tracking patients over time through physical health, mental health, and social services, spanning all levels of intensity.
