News & Analysis

March 1, 2021
Case Management Monthly

As of May 1, UnitedHealthcare, the largest health insurance company in the United States, will be switching from using Milliman Care Guidelines (MCG) to InterQual.

February 26, 2021
Case Management Monthly

Ellen, a case manager, works more than 40 hours every week on-site at her hospital. This has been her schedule since the novel coronavirus (COVID-19) pandemic restrictions were put in place. She is a single mother and decides, despite the virus risk, to work as many hours as possible.

February 24, 2021
Medicare Web

Q: What are the best strategies for case managers working with patients who have dealt with past trauma?

February 19, 2021
Case Management Monthly

The elimination of the IPO list is planned to be a gradual process that will take three years to fully implement. This year, CMS removed over 300 surgical procedures from the list, primarily cutting the list of musculoskeletal-related procedures, which was reduced from 1,700 to 1,441. The removal of these procedures from the IPO list allows doctors who perform them to be paid for procedures performed on an outpatient basis.

February 17, 2021
Medicare Web

Q: It's easy for case managers to feel overwhelmed during the novel coronavirus (COVID-19) pandemic. The workload has been burdensome for the past year, and many case managers are not able to strike the important work-life balance. What are some recommendations for reducing some of the stress and anxiety that has built up over the past year?

February 12, 2021
Case Management Monthly

The U.S. Department of Health and Human Services (HHS) has extended the current novel coronavirus (COVID-19) public health emergency (PHE), which is good news for organizations.

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