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A far-reaching redesign of the care coordination process at Norfolk, VA-based Sentara Healthcare has standardized the process across hospitals, centralized the administrative and clerical tasks that care coordinators must perform, and freed the staff at the bedside to concentrate on working with patients.
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A pilot program at MetroHealth Medical Center in Cleveland resulted in significant drops in emergency department visits among Medicaid recipients who were "ultra-users" of emergency care and participated in the one-year study.
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For years, the Centers for Medicare & Medicaid Services (CMS) state operations manual has had guidelines for surveyors to assess issues related to patient safety at hospitals. But there is such a wide range in size and scope of hospitals, says Marilyn Dahl, CMS director of the division of acute care services, that the organization decided it would be a good idea to create some sort of prompt for surveyors to use.
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To prevent readmissions when patients are transitioning from the acute care hospital to an inpatient rehabilitation center, case managers should make sure the patients are appropriate for acute rehab, that their medical conditions are stable, and that they can tolerate three hours of physical therapy every day.
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As we discussed last month, healthcare reform has changed the landscape of healthcare and of case management. Emerging trends and changes related to reimbursement, readmissions, pay for performance, outcomes and newly contracted reviewer agencies such as the Recovery Audit Contractors (RACs), have changed familiar payment methods and audits to new and different ones in a short amount of time.
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At St. Joseph's Hospital in Tampa, a multidisciplinary team collaborates with clinicians throughout the continuum to manage the care of heart failure patients.
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As reimbursement adjustments under the Centers for Medicare & Medicaid Services' (CMS) Value-based Purchasing (VBP) Program start to kick in this October 1, it's more important than ever for case managers to be pay attention to overall quality improvement and not just concentrate on particular patients or conditions, says Danielle Lloyd, MPH, vice president for policy development and analysis for the Premier healthcare alliance, with headquarters in Charlotte, NC.
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For years, the Centers for Medicare & Medicaid Services (CMS) state operations manual has had guidelines for surveyors to assess issues related to patient safety at hospitals. But there is such a wide range in size and scope of hospitals, says Marilyn Dahl, CMS director of the division of acute care services, that the organization decided it would be a good idea to create some sort of prompt for surveyors to use.
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The emergency department is evolving from being the gate of the hospital to being a front porch for the community, a central location where people with healthcare concerns can come and be triaged to the proper venue for care, says Karen Zander, RN, MS, CCMAC, FAAN, principal and co-owner of The Center for Case Management in Wellesley, MA.
