Hospital Case Management
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Bundled Payments Take a Lot of Work — So You Better Start Now
CMS has given providers only a short time frame in which to go live with their bundled payments programs — which makes it difficult for providers to prepare.
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Get Ready for Bundled Payments: They’re Coming Your Way
If your hospital is not in one of the geographic areas where the CMS mandated that hospitals participate in the Comprehensive Care for Joint Replacement program, don’t think you’ve dodged the bundled payment bullet.
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Training, Drills Pivotal in Mounting Response to Orlando Shooting
Emergency providers generally have some warning when a hurricane or another natural disaster poses risks to the community. However, that is rarely the case with a mass shooting, as was evident in the early morning hours of June 12, when a lone gunman opened fire inside the Pulse nightclub in Orlando, FL.
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Case Managers Offer Advice on Handling Mass Shootings
Case managers can help their health systems prepare for the effects of mass shooting by taking several additional emergency preparedness steps.
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Case Manager Leadership Needed in Mass Shootings, Major Traumas
U.S. hospitals handle, on average, victims from a mass shooting every day. For most case managers, it’s not a matter of whether they and their colleagues will experience that traumatic event, but when.
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Case Management-Revenue Cycle Partnership Pays Off
At Saint Francis Hospital in Hartford, CT, the revenue cycle team is a strong partner of case management, reports Beth A. Greig, RN, MSN, MBA, ACM, director of case management, healthcare value, and efficiency at the 617-bed hospital.
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CMS Issues Temporary Halt to Short Stay Reviews
Faced with concerns from providers and apparently inconsistent education being provided by the Beneficiary and Family Centered Care Quality Improvement Organizations, CMS temporarily suspended reviews of short hospital stays and ordered the QIOs to re-review every denial issued since they took over the reviews.
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Project to Improve Throughput Cut Length of Stay, Helped Bottom Line
A quality improvement project to shorten lengths of stay and improve throughput from the ED at Saint Francis Medical Center in Hartford, CT, decreased the length of stay by more than half a day from November 2015 through May 2016.
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Know the Payer Rules to Maximize Reimbursement
In today’s world, it is imperative for the case management director to make sure the case management staff receives continuous training and education around payer rules and regulations, and the financial implications of what they do, says Mindy Owen, RN, CRRN, CCM, principal owner of Phoenix Healthcare Associates in Coral Springs, FL, and senior consultant for the Center for Case Management.
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Review Every Patient, Every Day to Ensure Appropriate Reimbursement
When case managers concentrate only on getting the patient status right up front and then review only selected patients and review them every few days, it’s likely to have a big effect on the financial health of the hospital, says Brian Pisarsky, RN, MHA, ACM, associate director of Emeryville, CA-based Berkeley Research Group.