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In the December 2011 issue of Case Management Insider we discussed the roles most commonly used by case managers in today's acute care setting. These included the following:
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Salaries for case managers are increasing but the vast majority of case managers are working far more than the typical 40-hour week, according to the 2011 Hospital Case Management Salary Survey.
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A multi-disciplinary initiative to make sure patients receive care in the right setting at the right time for the right reason has resulted in a drop in length-of-stay at the two hospitals in the Memorial Health Care System in Chattanooga, TN.
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In order to facilitate smooth transitions between levels of care and ensure that patients continue to recover after they are discharged from the hospital, Baystate Health, with headquarters in Springfield, MA, is partnering with post-acute providers and meeting regularly to discuss opportunities for improved patient care and partnership.
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If you're not paying as much attention to documentation and medical necessity for Medicaid patients as you do for those covered by Medicare, your hospital is likely to suffer when the Medicaid Recovery Audit Contractor (RAC) program starts on Jan. 1, 2012.
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(Editor's note: This is a multi-part series where we will explore the most common roles, functions, models, and caseloads in the hospital case management field.)
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Key components of the initiatives include forging an alliance with post-acute providers, transition coaching for at-risk patients during the hospital stay and after discharge, and teaching patients to use their personal health record to track their care and list questions for providers, according to Tammy Cole-Poklewski, RN, MS, director of quality, patient safety, and care management at the 142-bed facility.
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After Charleston (WV) Area Medical Center began a readmission reduction program, readmission rates for a group of targeted heart failure patients was reduced by 50%.
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In response to comments from healthcare professionals, the Centers for Medicare and Medicaid Services (CMS) made significant changes to the final rule for the creation of accountable care organizations (ACOs), which encourage providers to better coordinate care across all settings.
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When it's typical for patients to wait four hours or more to see an emergency physician, and your leave-without-being-seen (LWBS) rate is pushing 10%, you know it's time to rethink the whole process.
