November 1, 2010
Case Management Monthly

CMS has seen an increase in the number of extended observation stays and wants to know why. That was the reason it gave for holding an August 24 listening session regarding the matter. The reason providers misuse observation services may not have been as interesting as the solution proposed by some callers—namely, that CMS should abolish observation services. 

November 1, 2010
Case Management Monthly

Project BOOST (Better Outcomes for Older Adults Through Safe Transitions) is gaining popularity among providers nationwide as a method to reduce preventable hospital readmissions. Since the program began in September 2008, more than 1,400 facilities have downloaded the free toolkit from the Society of Hospital Medicine’s (SHM) website, and 65 sites have enrolled in the mentorship program. (See the “All about BOOST” sidebar below for more information on Project BOOST.)  

November 1, 2010
Case Management Monthly

As the case manager’s role has matured, specific best practices have proven to be a valuable conduit to the provision of care coordination, outcome achievement, and quality of care. 

November 1, 2010
Case Management Monthly

The case management team has a difficult time finding a psychiatric unit for a bipolar patient.

October 1, 2010
Case Management Monthly

One setting alone doesn’t possess all the services required to fulfill a patient’s needs. Employees at each setting have different talents, skills, and knowledge needed to achieve all the care needs.

October 1, 2010
Case Management Monthly

To begin to think about separating the UR function from the case management role, you must question the validity of the functional model

October 1, 2010
Case Management Monthly

Private care managers assist patients who have complex care needs such as coordination of multi-specialty appointments, medication management, and transportation.

October 1, 2010
Case Management Monthly

Several case managers have recently received denial letters from their regions’ Medicare Advantage (MA) for medically necessary readmissions.

October 1, 2010
Case Management Monthly

Teaching noncompliant patients how to cheat seems counterproductive, but this strategy saved lives in one medical center’s renal patient population.

September 1, 2010
Case Management Monthly

Many of us dream of the day when our department achieves its targeted LOS; however, LOS perfection can create new problems

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