There's bad news for case managers that were hoping that the 2-midnight rule would go away. It's not?at least not in fiscal year (FY) 2015. In the 2015 Inpatient Prospective Payment System (IPPS) final rule published August 22, CMS said while it may be willing to look into adjusting the payment methodology for the 2-midnight rule, the rule itself will stand.
Physicians have long treated patients knowing that some of the problems keeping them sick were problems that medicine couldn't fix--lack of food, electricity, or money to pay for medicine. These are the types of problems that often send patients back to the hospital after they are discharged home. Today, some physicians can write a prescription to solve these problems the same way they order medicine.
Many hospitals have been adding group rounds as a means of improving communication and care for patients. These rounds give case managers (CM) an opportunity to better understand the patient's condition, learn about any potential factors that might extend LOS, and prepare for any potential barriers that might lead to readmission after discharge.
It's time to get the recognition you deserve and put the focus on your department by celebrating National Case Management Week, scheduled this year October 12-18.
Some hospital case managers may be breathing a small sigh of relief because a provision in the 2015 OPPS proposed rule would, if finalized, put an end to a burdensome physician inpatient certification requirement for most patients.
In the middle of a heated conversation the angry family member of a patient blurts out, "I think it's time to call my lawyer. I'm going to sue." These are words that can strike fear into the most steadfast case managers. After all, lawsuits can be time-consuming and potentially costly.
