Hospital Case Management – January 1, 2013
January 1, 2013
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Hospital industry pushes back against the RACs
After years of being frustrated by the Centers for Medicare & Medicaid Services Recovery Audit Contractor (RAC) program and other audit programs, the hospital industry is taking action. Heres the latest: -
ZPICs focus on hospital staff credentials
In addition to losing reimbursement when cases dont meet medical necessity, hospitals face additional lost revenue if the credentials of all personnel who provide care for patients are not up to date and the staff are performing interventions for which they are not licensed. -
Nurses scrutinize records before bill drops
Medical City Dallas Hospital is taking a proactive approach to Medicares prepayment review process. -
CMs work overtime in Sandy’s wake
Days before Hurricane Sandy roared through the East Coast, the case management staff at Lutheran Medical Center in Brooklyn was working overtime to discharge patients and free up beds for patients injured in the storm or being evacuated from other hospitals and skilled nursing facilities. -
Transitions are key in cutting readmissions
A key to the success of Monmouth Medical Centers readmission program is ensuring that patients get the care they need after discharge and understand their treatment plan and medication regimen. -
Culture change improves ED throughput
When Bronson Methodist Hospital in Kalamazoo, MI, examined throughput in the emergency department, it determined that a culture change was needed to shorten wait time and make sure patients meet inpatient criteria and are admitted in the right status. -
Hospital flu shot rates entering the public realm
Your influenza vaccination campaign is coming into the public spotlight, and that means more pressure than ever on the logistics of administering and tracking those vaccinations. -
2012 Salary Survey Results: CMs more appreciated but budgets are tight
Healthcare reform initiatives such as value-based purchasing and readmission reduction, and a growing emphasis on quality have heightened awareness of case management, says Toni Cesta, RN, PhD, FAAN, senior vice president, operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, NY, and partner and consultant in Dallas-based Case Management Concepts.