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The case management department at Lee Memorial Health System in Fort Myers, FL, has been able to demonstrate a savings of $4.5 million as a result of having case managers in the emergency department.
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If you have the emergency department volume and the staffing, covering the emergency department 24 hours a day, seven days a week is optimal, according to Joanna Malcolm, RN, CCM, BSN, consulting manager, clinical advisory services for Pershing, Yoakley & Associates in Atlanta.
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When patients are admitted to the hospital inappropriately, the paperwork involved to correct the error brings to mind the saying "an ounce of prevention is worth a pound of cure."
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Today's hospitals are facing a shrinking pool of healthcare dollars along with increased scrutiny from Medicare, Medicaid, and commercial payers and strong penalties for fraud and abuse.
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It's a new era for hospitals and for case managers as a multitude of auditors from the Centers for Medicare and Medicaid Services (CMS) and commercial payers scrutinize patient records looking for errors.
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To maintain stability and effectiveness in meetings, the following steps should be considered.
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The devil is in the details when it comes to convening a successful interdisciplinary meeting.
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It is expected that metrics will be available so that the contributions of case management are quantified, as outlined by Toni Cesta, PhD, RN, FAAN, senior vice president, Lutheran Medical Center, Brooklyn, NY, in her April 2011 Case Management Insider article "You're only as good as yesterday's discharges Strategies to demonstrate case management's value."