Hospital Case Management – March 1, 2016
March 1, 2016
View Issues
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Financial stakes rising as auditors set their sights on providers
The Centers for Medicare & Medicaid Services is continuing to tweak its various audit programs, and the changes make it imperative that case managers stay current so they can educate the rest of the staff.
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Get status right up front for fewer headaches later on
As CMS’ audit program evolves, it’s crucial for hospitals to prevent denials on the front end.
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CMS gives the RA program a makeover with more changes in store
CMS has made changes in the scope of work for the Recovery Auditor program and has proposed a number of other changes to be implemented when new RA contracts are issued.
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Safety net hospital, community providers collaborate to improve transitions
A Care Transitional Task Force at San Francisco General Hospital created a cross-continuum program that has reduced readmissions and increased timely primary care visits for discharged patients.
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Transitional coordinator nurses focus on at-risk patients with chronic diseases
Tucson Medical Center keeps its readmission rates low by having transitional coordinators work closely for patients with chronic disease who are at risk for readmissions.
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Readmissions are focus of TJC resources
The Joint Commission has developed two new resources to help healthcare providers in their efforts to reduce patient readmissions and improve the discharge process.
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Hospital safety scores show some improvements
The Hospital Safety Scores released recently by The Leapfrog Group show key shifts among many hospitals on the letter grades rating them on errors, injuries, accidents, and infections.
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A burnout barometer to assess your work culture
The American Association of Critical-Care Nurses has created tools to address issues associated with a healthy work environment, including burnout and “compassion fatigue."
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Thinking of Separating Utilization Management and Case Management? Think Again!
The more siloed your department, the more likely that the staff will resort to tasks rather than looking at all of the elements and data associated with the patient in an integrated fashion. This month, we will talk about the pros and cons of separating utilization management out from the role of the case manager.