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While the 12-hour work day has become the norm for nurses, there is new evidence that such longer shifts are not necessarily a good idea, especially when nurses work several consecutive days involving 12-hour shifts, or they are required to put in excessive amounts of overtime.
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To make a go of it as an independent practitioner, case managers must have a strong desire to do the job, know the rules and regulations involved in their profession, stand firm and resist the pressure to veer from doing things the right way, says Brenda Keeling, RN, CPHQ, CCM, president of Patient Response, Inc., a Durant, OK, healthcare consulting firm specializing in regulations and compliance.
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Its great to be on your own, make your own schedule, and do the work you love, but there are a lot of challenges associated with starting and maintaining a business as an independent case manager.
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Independent case managers should purchase malpractice insurance to protect themselves from possible legal action if the patients whose care they manage experience an adverse outcome, says Elizabeth Hogue, Esq., a Washington, DC, attorney specializing in healthcare issues.
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If youre tired of the same routine, dealing with your organizations bureaucracy and policies and procedures, and being just another employee who has to take the cases your supervisor gives you, it might be time to look into starting your own case management business as a solo practitioner.
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Many EDs have found ways to streamline their triage processes and slash door-to-provider times. Such department-level improvements are important, but eventually ED administrators have to deal with the inpatient side of the equation for those patients who need to be admitted for further treatment.
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Its not just enough to be a terrific case manager. To become a solo practitioner, you also need to be able to market yourself.
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In the recent Office of Inspector General (OIG) opinion regarding co-management, the OIG noted that the arrangement was not protected by any Anti-Kickback Statute safe harbor because the aggregate payment to the group was not set in advance, explains Janice Anderson, JD, shareholder with the law firm of Polsinelli Shughar in Chicago.
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The Centers for Medicare & Medicaid Services (CMS) proposed rule for the 2014 Inpatient Prospective Payment System (IPPS) is subject to change, but hospital case managers still should familiarize themselves with the rule and determine the impact, says Ralph Wuebker, MD, MBA, chief medical officer for Executive Health Resources, a Newton Square, PA, physician advisor company.
