The IPPS 2019 final rule, released August 3, formally reversed the CMS requirement that a physician’s order must be in the medical record for the hospital to bill for inpatient services under Medicare Part A. But it hasn’t eliminated all the associated headaches related to inpatient admission orders.
The powerful data analytic tools used for predicting patients at risk for high healthcare utilization, healthcare costs, and mortality are essential to a successful population health model of care.
Many case management directors have questions that arise from time to time on a variety of topics. Here are two such questions along with responses that may help if you’re facing similar challenges.
A case manager works on a postacute transfer plan for a patient who is critically ill with sepsis and at risk for acute renal failure. Because the patient has a history of IV drug use, it is likely that long-term acute care hospitals will deny him admission.
Q: Sometimes a patient doesn’t understand his or her conditions enough to do what he or she can to prevent readmission. Any tips on what a case manager can do to empower patients to learn about their health?
