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The Centers for Medicare & Medicaid Services (CMS) has granted hospitals a temporary reprieve from a reduction in Medicare payments.
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If you want to convince your hospital administration to approve case managers in the emergency department, you have to put together a plan that outlines why doing so would be in the hospital's best interest, suggests Toni Cesta, RN, PhD, FAAN, senior vice president, operational efficiency and capacity management at Lutheran Medical Center in Brooklyn, NY, and health care consultant and partner in Case Management Concepts LLC.
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By providing care coordination throughout the continuum for patients with multiple chronic conditions, the Sacramento Sierra Region of Sutter Health has significantly decreased emergency department visits and hospitalizations.
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Increased communication among the multidisciplinary patient care team has increased patient throughput at Duke University Hospital, a 924-bed acute care facility in Durham, NC.
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Hospital reimbursement is being squeezed from all sides. In the proposed Inpatient Prospective Payment System rule for fiscal year 2010, the Centers for Medicare & Medicaid Services (CMS) has proposed slashing the Medicare reimbursement update to account for improvements in documentation and coding and limiting reimbursement for readmissions.
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Hospitals are losing large amounts of money on extra and inappropriate diagnostic testing and procedures, as well as outpatient procedures performed in the inpatient setting because third-party payers frequently are denying the claims, says Brenda Keeling, RN, CPHQ, CPUR, of Patient Response, a Milburn, OK, health care consulting firm.
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By analyzing claims data to assure that the hospital was reimbursed appropriately and aggressively appealing all denials and underpayments of claims, DCH Health System in Tuscaloosa, AL, was able to generate a 1.25% increase in net patient revenue.
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Faced with a high census and backups in the emergency department, Bay Medical Center in Panama City, FL, created two discharge areas where patients who were waiting for transportation to home or a nursing home could wait, freeing up much-needed beds on the units.
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By involving patients and family members in the treatment plan and discharge process before they are admitted to the hospital for treatment, the staff at Moffitt Cancer Center in Tampa, FL, within a five-month period of time decreased length of stay by almost two days and achieved a 7% increase in the number of admissions involving hematology patients.
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As emergency department case manager, Janeice Garrison, RN, MSN, BC, sees herself as the "point guard" for the hospital in a large, mostly rural area where the population is growing by an average of 22.4% a year and the percentage of uninsured, undocumented, and homeless patients is increasing.
