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No matter what model of accountable care organization (ACO) the Centers for Medicare and Medicaid Services (CMS) settles on, case managers are sure to be key players as providers focus on managing care efficiently and effectively across the continuum.
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Sumner Regional Medical Center in Gallatin, TN, offers good evidence that quick-turnarounds are indeed possible when you have motivated staff.
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A social work presence in the emergency department (ED) is critical to the effectiveness of the case management process.
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At Cheyenne (WY) Regional Medical Center, recovery audit contractor (RAC) determined that a significant number of surgical one-day inpatient stays should have been billed as observation.
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A program that provides support for uninsured patients has saved $4.56 million over 18 months at Memorial Hermann Healthcare System in Houston.
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Not only is the emergency department (ED) not just for admissions, but it has become a key and strategic element of today's case management departments. A primary route of entry for many patients across the United States, it can make or break a hospital in today's highly audited environment.
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The emergency department (ED) case manager has four principal roles that should be observed. Those role are as follows:
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Recognizing that hospital readmissions are costly for providers and insurers alike, Blue Cross and Blue Shield of Illinois and the Illinois Hospital Association are collaborating on a quality initiative to reduce the rate of hospital readmissions.
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The Affordable Care Act (ACA) contains provisions for offering financial incentives for wellness participation in workplaces, which is good news for occupational health. However, the American Heart Association and the American Cancer Society have created a coalition to persuade federal regulators to prohibit financial incentives for Health Risk Assessments when family history items are involved.
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Almost three in four (71%) of hospital-based health care workers received their flu vaccine last year, showing a sustained commitment to vaccination even after the pandemic subsided, according to a survey conducted by the Centers for Disease Control and Prevention.
