CMS began rolling out new cards to Medicare beneficiaries in April and recently announced that wave one of the mailing has been completed. The new cards are intended to help protect beneficiaries’ Social Security Numbers.
Two recent high-profile celebrity suicides and news from the Centers for Disease Control and Prevention (CDC) that suicide rates are on the rise across the country have prompted some healthcare professionals to look more closely at suicide prevention and whether more can be done to help individuals struggling with mental illness.
Health literacy can have a major impact on patient outcomes. If a patient doesn’t understand his or her condition, the reasons for treatment, and how to properly take medication, the patient could experience a relapse or adverse reaction.
Ms. P arrives on a medical unit at a major medical center escorted by two armed police guards from the local jail. The social worker, Ann, asks about the reason for the guards and the length of time that they will be on the unit, but the officers tell her they can’t share this information.
Case managers are a valuable component of any healthcare facility’s care team, whether they are in discharge planning or utilization management roles. As healthcare evolves, so too do the roles and expectations for the facility’s staff, making it critical for case managers and other team members to periodically evaluate whether their career goals align with their current work.
Social determinants of health are social factors, such as homelessness, illiteracy, a history of childhood trauma, and joblessness or underemployment, that can affect a person’s health. Coding for these factors is important because CMS officials now use some of them to adjust quality measures for patients who are dual-eligible for Medicare and Medicaid, and coding these factors may help shape future health policy.
Case managers must begin to learn the skill of brokering for care. The goal of private payers is to provide the most cost-effective care that meets medical necessity for services and increases likelihood for recovery.
Anita is a 76-year-old patient who cannot be insured. She has no income and came to the U.S. on a green card that expired many years ago. Anita has end-stage renal disease and can no longer care for herself. Her disease has progressed so dramatically that she will never be able to stand or walk on her own again. What can a case manager do in this complex case to ensure Anita receives care?
If provisions of the 2019 IPPS proposed rule related to admission orders become a reality in October, case managers could be relieved of a big headache. If this portion of this rule is finalized, CMS would reverse the requirement that a physician’s order must be in the medical record for the hospital to bill for inpatient services under Medicare Part A.
