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When it comes to ensuring that patients are receiving high-value, cost-effective care, case managers are where the rubber hits the road, says Michael Taylor, MD, vice president of operations at Executive Health Resources, a Newton Square, PA, healthcare consulting firm.
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After Bassett Medical Center in Cooperstown, NY, began a multidisciplinary program to reduce readmissions, the 30-day readmission rate for high-risk patient diagnoses dropped 70% from 13.4% in 2009 to 0.7% 2010. The initiative earned the medical center a Pinnacle Award for Quality and Patient Safety from the Hospital Association of New York State.
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A pilot program in which parents or caregivers of patients were screened for health literacy reduced healthcare costs and emergency department use for patients at Cook Children's Medical Center in Fort Worth, TX.
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Systems will need to be remediated if they will be used to check medical necessity for ICD-10 standards when they are implemented in October 2013, says Jeffrey Smith, RN, MBA, CPC, a New York City-based manager at Accenture Insight Driven Health, a management and technology consulting company.
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As the clock ticks down toward the implementation of ICD-10, case managers should start learning about the new coding requirements and how they are going to affect what they do on a daily basis.
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As case management leaders, you will be looking for the next generation of case managers to come from the bedside. The following information will review the process you might consider using to facilitate recruitment of staff to your department.
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In October's edition of Case Management Insider, we discussed the importance of using good recruitment and retention strategies in the case management department. Because recruitment is an essential component of retention, this month we will focus on the next generation in case managers: the staff nurses!
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If one of your registrars followed payer requirements to obtain a required authorization, it might become a "he said/she said" situation if the claim is later denied.
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After Betty Bopst, director of patient access at Mercy Medical Center in Baltimore, MD, finishes telling a patient access applicant the extent of the commitment that comes with the job, he or she sometimes tells her flat out, "This job is not for me."
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If you don't pay this bill, we're going to send you to a collection agency." This was a commonly heard statement by patients at Tallahassee (FL) Memorial HealthCare, when Joan S. Braveman, director of patient access and financial services, took over the business office.
