Hospital
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Waiting for Outcomes of Legal Challenges Unwise
Two healthcare attorneys advise medical facilities to proceed as though the rule requiring the disclosure of secret negotiated rates will go forward as planned.
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Price Transparency or Price Gouging: Disclosure of Negotiated Rates Called a ‘Tipping Point’
How much does a health insurance company pay the hospital for an MRI? Nobody really knows — except the hospital and payer. That is about to change, thanks to a new rule that requires hospitals to disclose secret negotiated rates with payers.
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The Case Manager’s Toolbox: The Essential Skills of an Effective Case Manager, Part 1
The RN case manager’s expertise is the vital link between the individual, the provider, the payer, and the community. Successful outcomes cannot be achieved without using specialized skills and knowledge applied through the case management process.
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CMS 2020 Final Rules: Inpatient and Long-Term Acute Care
Antimicrobial resistance represents a serious risk for Medicare beneficiaries and the general public. CMS is finalizing an alternative new technology add-on payment pathway for antimicrobial products designated by FDA as Qualified Infectious Disease Products.
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Technology Solutions for Diabetes Care Management Vary in Effectiveness
Investigators recently studied technological solutions to improve diabetes patients’ engagement. They found multiple digital diabetes management systems that could help. These solutions include smartphone apps, devices with built-in connectivity, and coaching and support provided remotely through human or automated connections.
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Strategic Program Shortens Urban Hospital’s Length of Stay
As urban hospitals grapple with length of stay penalties, they must help their patients solve everyday problems. Lack of resources is a fact of life for inner city residents, and hospitals need to find a way to help those patients overcome those obstacles — and reduce length of stay.
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Hospital Collaborates With EMS to Bring Case Management to Homes
An Ohio hospital’s population included people with lower income, less education, and many health challenges. Case management could help once these people entered the hospital, but the challenge was to prevent the problems that first led to ED visits and rehospitalizations.
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‘Person-Centered’ vs. ‘Patient-Centered’ Care
Long-term support services should provide “person-centered care,” according to a 2014 rule from CMS. In everyday patient care, this translates into a focus on learning a patient’s wants and needs, which helps the case manager align treatment with the patient’s desires.
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Value-Based Care: Tips for Case Managers
Hospitals are struggling to meet the goals of value-based payment models. Value-based models are designed to improve outcomes, such as quality of care, satisfaction, and complications, while reducing costs. The impetus comes from CMS, which has set quality and efficiency standards for hospitals.
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To Build a Case Management Team, Focus on Engagement
There is not one specific way to improve case management and develop the best teams. But a good first step is to identify team members and to focus on the correlation between their skill sets, engagement, and outcomes.