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A proposal by the Centers for Medicare & Medicaid Services (CMS) to include nearly half of the existing diagnosis-related groups (DRGs) covered by the post-acute care transfer rule will cut Medicare payments to hospitals by $880 million a year, or approximately 1.1% of Medicare payments, according to the Chicago-based American Hospital Association (AHA).
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Readmission rates, average length of stay (LOS), and cost per case for children with low-acuity asthma improved after a clinical redesign initiative at the University of Michigan C.S. Mott Childrens Hospital (UMMCH) in Ann Arbor.
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With the help of case managers, the average length of stay has significantly decreased without adversely impacting quality or outcomes. In todays economic atmosphere, you must be able to positively impact the length of stay as well as maintain our high standard for quality of care, says Pat Eason, RN, BSN, administrative director for case management services at HUMC.
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For some quality teams, being good is just not good enough. That was certainly the case at Providence Hospital, part of the St. John Health System in Southfield, MI.
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When the case management department at University of Wisconsin Hospitals and Clinics implemented a series of initiatives to improve the throughput of patients, the average length of stay for surgical patients dropped from 7.9 days to 4.6 days and overall length of stay dropped from 6.3 days to 5.1 days including all the outliers.
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A pilot project under way at Arnot Ogden Medical Center in Elmira, NY, is assessing how likely patients are to adhere to their prescribed medication regimen, with the ultimate goal of helping them to become more compliant, says Tina Davis, RN, MS, CNS, senior director of continuum of care.
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Collaboration between key hospital departments is crucial to making sure discharge planning starts at the earliest possible point in the patient encounter, and the latest advances in technology certainly can facilitate the necessary interdepartmental communication.
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Case management directors struggle daily with how best to assign caseloads to their staff, but its not enough to rely on benchmarks of caseload statistics. Many other factors can affect how many patients a case manager can manage adequately, experts say.
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Commissioners with the Commission for Case Manager Certification (CCMC) frequently are asked in many forums, such as conferences, how applicants can study and prepare for the Certified Case Manager (CCM) certification exam.
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Hospital case management should be a team approach, with everyone on the team looking at what needs to be done for the patients and making sure it gets done, says Judith Martin, RN, CCM, director of medical management for Regional Medical Center, a division of Trover Foundation, a nonprofit health care organization in Madisonville, KY.
