Case Management

The American Case Management Association (ACMA) Public Policy Committee is in communication with CMS to change the requirements for the second Important Message from Medicare (IM).

Case managers can do their part to make sure their hospital's case-mix index is as high as possible.

Denial prevention begins by establishing channels that lead to a systematic review of each patient’s admission.

A patient's high-profile spouse makes discharge planning a challenge.

Use data to identify weakness in your case management department processes and reduce revenue cycle risk.

No matter whom the CDI department reports to, collaboration between case managers and CDI specialists will improve patient care.

The following are the highlights from the 2010 Case Management Monthly salary survey. We received more than 300 responses from case managers (64%) and case management directors (36%) from all over the country. Social workers were not included.

Experts expect the RACs to begin auditing medical necessity this summer. Case managers may be asked to play a large role in appealing medical necessity denials because of their involvement in level-of-care determinations. To help case managers, we asked Medicare appeals experts to explain the case manager’s role in the appeals process.

Case managers and discharge must understand patients’ perspective to make sure patients clearly understand the discharge instructions.

Untreated mental conditions can prevent patients from properly managing physical health, thus causing the patient to be readmitted to the hospital, which is why case managers should coordinate mental and physical treatments.