-
As the Centers for Medicare & Medicaid Services (CMS) rolls out the Recovery Audit Contractor (RAC) program nationwide, case managers are in a position to help their hospitals stay ahead of the curve by keeping patients out of the hospital if they don't need to be admitted and ensuring that the documentation in the medical record for inpatient or observation admission supports medical necessity.
-
Since Baptist Memorial Hospital-Memphis began a patient throughput initiative, the patient holding hours in the emergency department and post-anesthesia care unit average less than 30 hours per day despite the fact that 50,000 patients come through the emergency department each year and the hospital has more than 30,000 inpatient visits a year.
-
When patients of community-based physicians are ready for discharge from Chesapeake (VA) Regional Medical Center, they no longer have to wait for their physicians to come to the hospital and write discharge orders.
-
At DCH Health System, the clinical documentation improvement team takes a proactive approach to changes in the Centers for Medicare & Medicaid Services (CMS) documentation requirements.
-
Automobile and accidental injury regulations, the Medicare as Secondary Payer questionnaire, and workers' compensation guidelines are just a few of the many issues with which the patient access professional and case manager must be educated and competent.
-
An enterprisewide master patient index is used at Methodist Le Bonheur Healthcare, a system of six hospitals, several off-campus diagnostic and treatment centers, free-standing surgical centers, and urgent care centers.
-
-
A chronic care program for diabetics at St. Elizabeth Health Center in Tucson, AZ, provides recommended care at a reduced cost and copay, helps them develop self-management goals, and supports them when they go back into their communities.
-
Monthly diabetes group visits, where patients receive all their recommended tests and examinations in one place, are an effective and cost-efficient way to help diabetics keep their disease under control, but they take a lot of organization, says Donna Zazworsky, RN, MS, CCM, FAAN, manager of network diabetes care, faith community nursing and telemedicine for Carondelet Health Network in Tucson, AZ.
-
Promotoras, or specially trained community health workers, help bridge the gap between members of the community and the medical providers at St. Elizabeth Health Center in Tucson, AZ.
