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Most of the items in in the box "Characteristics and Core Competencies of Potential Candidates" (below) are inherent and/or learned over time.
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When the Inpatient Prospective Payment System (IPPS) final rule for 2012 was issued, the Centers for Medicare and Medicaid Services (CMS) stated that its goal is to encourage hospitals to provide higher quality of care at a lower cost and to promote greater efficiencies across all care settings and throughout the entire health system.
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A year after Saint Joseph-London Hospital in London, KY, began a heart failure readmissions program, 30-day readmissions dropped from 27.7% to 15.9%. A similar program for patients admitted for acute myocardial infarctions (AMI) reduced the readmissions rate from 23% to 10% in a short time.
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At Pennsylvania State University (Penn State) Milton S. Hershey Medical Center in Hershey, PA, a long-term acute care liaison evaluates patients with complex needs for potential placement in a long-term acute care hospital (LTACH), coordinates a comprehensive plan for transition with the treatment team, and works with the accepting facility and the patients' insurers to ensure a smooth transition.
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Where will we find the new case managers and what will the new candidate look like? They might not be the seasoned clinician as you would hope for. As we need more and more case managers and social workers, some of us might need to look even more broadly for our candidates.
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The recruitment and retention of good case managers has never been more important than it is today. In the early years of hospital case management, many case managers transitioned into the role from utilization review or discharge planning positions.
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A pilot project providing coaching and follow up for heart failure (HF) patients who are readmitted frequently resulted in a 50% drop in the readmission rate at Indiana University (IU) Health Ball Memorial Hospital in Muncie, IN.
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After Summa Health System and Akron, OH, area nursing facilities formed the Care Coordination Network to improve communication throughout the continuum of care, lengths of stay and readmissions for patients transferred to facilities in the network dropped.
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"We're entering the Golden Age of Case Management. The Affordable Care Act, the Accountable Care Organization initiatives, and other patient-centered, value-based models of care all recognize the value of case management.
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Senior citizens and their families are getting help in identifying and coping with the medical and social needs of the elderly through a Geriatric Assessment Program offered by Geisinger Health System, with headquarters in Danville, PA.
