Hospital Case Management – February 1, 2013
February 1, 2013
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Don’t think the Recovery Auditors will disappear
Hospitals may eventually receive some relief from the burdens of the Centers for Medicare & Medicaid Services (CMS) Recovery Auditor (RA) program (previously called the Recovery Audit Contractor [RAC]) program but dont think the RAs are going away. -
Appeal, appeal, appeal those denials
Hospitals that appeal their denials by the recovery auditors (RAs) recoup their money 75% of the time, according to data provided by the American Hospital Association. But, only 40% of denials are appealed. -
Keep informed about RA focus in your area
The American Hospital Association reports that 88% of all hospitals responding to its RACTrac Web-based survey have received an audit under the Recovery Auditor (RA) program. -
CM redesign cuts LOS, readmissions
Since University Hospitals Case Medical Center in Cleveland, OH, embarked on a quality improvement initiative that included a redesign of the case management process, length of stay has dropped by almost a full day, readmissions have decreased, and the hospital's performance on 30+ metrics has increased. -
Team huddles improve LOS, core measures
After Springfield Regional Medical Center in Springfield, OH, began daily multidisciplinary team huddles to facilitate patient care, the hospitals performance on targeted core measures rose to the 95th quartile compared to a range of 75% to 81% when the project began, and the housewide ratio of the observed-to-expected length of stay decreased from 1.15 to 1.07. -
Short huddles focus on plan of care
The multidisciplinary team on each unit at Springfield Regional Medical Center in Springfield, OH, holds short team huddles at a specific time every day and reviews each patient, the plan of care and goals, and what needs to happen each day. -
Study links HCAHPS, readmission rates
If your hospital receives high scores on the Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS), 30-day readmission rates are likely to be low, according to a study by Press Ganey, a South Bend, IN, health care performance improvement organization. -
Safe lifting becomes standard practice
Safe patient handling should be standard practice, not best practice. That is the message behind new, draft standards issued by the American Nurses Association (ANA). -
Case Management Insider: Managing Length of Stay Using Patient Flow Part 1
The focus on patient flow in the hospital setting began in the 1990s, when emergency department (ED) overcrowding became a serious threat to patient safety and quality of care.