News & Analysis

June 1, 2015
Case Management Monthly

More and more hospitals are choosing to become part of Accountable Care Organizations (ACO) in an effort to streamline patient care and reduce costs. If your organization is considering joining an ACO, you may have questions about how these groups work and how the change might affect your job. CMM asked several experts for the lowdown on what the transition to an ACO might mean for case managers.

June 1, 2015
Case Management Monthly

Whether it's a precautionary CT scan that may not really be needed or a duplicate laboratory test ordered by separate physicians, many hospitalized patients are getting unnecessary tests, and experts say it's a big problem.

May 1, 2015
Case Management Monthly

In November 2014, CMS put its certification requirement under the 2-midnight rule to bed, finally conceding that the rule was creating more problems than it solved. While many frustrated case managers celebrated this development, they still aren't completely off the hook. CMS replaced the global certification requirement with two more-specific certification requirements that went into place on January 1, and case managers need to be aware of them.

May 1, 2015
Case Management Monthly

Condition codes can cause considerable confusion for case managers. Coders use them to support payment for out-of-the-ordinary situations?for example, an inpatient being changed to outpatient status.

May 1, 2015
Case Management Monthly

EDs have a lot to handle. One in every three Americans will visit an ED each year, and among those are a number of populations that bring special challenges.

April 1, 2015
Case Management Monthly

Many of the facilities that once specialized in mental health services across the country have shut their doors in recent years, making it more likely than ever that hospitals will encounter patients with mental health needs in the emergency department (ED).

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