Case Management Newsletters

This newsletter offers case studies, best practices, and how-to analysis to help case managers move patients through the care continuum efficiently and safely.

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Case Management Monthly

Issue 12, December 1, 2008 - VIEW THE FULL ISSUE

• Taking an interdisciplinary approach to attacking avoidable days

  As facilitators and coordinators of patient care services, case managers are in the best position...

• Data collection, analysis lead to positive outcomes

  Recovery audit contractors (RAC), present on admission, and January’s loss of the Program to...

• Case managers and documentation specialists: Collaboration for improved documentation and communication

  The relationship between clinical documentation specialists (CDS) and case managers is not...

• Maximizing your PA program: How one facility uses PAs to create a team approach to patient care

  If you are not taking advantage of the expertise your physician advisor (PA) can offer to your case...

Issue 11, November 1, 2008 - VIEW THE FULL ISSUE

• Manage your fear of the RAC

  CMS’ Recovery Audit Contractor (RAC) program elicits feelings of fear, but Brenda Keeling...

• Make advocacy and quality the focus of a comprehensive case management program

  If your case management program is like most, it focuses mainly on utilization review and discharge...

• Ask June

  Hospitalists, who specialize in the management of hospitalized patients, take over for PCPs when...

• Transforming the elective precertification process

  The corporate care management staff at the University of Pittsburgh Medical Center (UPMC) knew its...

Issue 10, October 1, 2008 - VIEW THE FULL ISSUE

• LOS initiative saves one facility more than $1 million

  When New Hanover Regional Medical Center (NHRMC) in Wilmington, NC, wanted to decrease LOS...

• Improving nurse and case manager relations

  As a case manager, your job inevitably involves working with a variety of people each day to...

• Say yes to best practices in denial prevention

  Today, hospitals are facing many challenges: Shrinking payer sources, increasing charity care...

• Collaboration accelerates discharge planning process

  St. Luke’s Episcopal Hospital in Houston had several problems in its ICU: LOS rates had...

Issue 9, September 1, 2008 - VIEW THE FULL ISSUE

• Where case management sits in the POA puzzle

  $23,772: That's the projected average annual loss per hospital starting October 1, when Medicare...

• Reaching out to the disadvantaged obstetrics population

  The nurses in the Maternity Care Coordinator Program office in the birthing center at Prince...

Issue 8, August 1, 2008 - VIEW THE FULL ISSUE

• Improving communication to create a collaborative case management program

  When the two largest Grand Rapids, MI, hospitals merged in 1998 to form Spectrum Health, the case...

• Recruiting and retaining quality case managers

  If there are two things top corporations understand and execute better than anyone, it is the...

• Rewiring the discharge planning process

  Sutter Health Sacramento Sierra Region in California recognized that there was room for improvement...

Issue 7, July 1, 2008 - VIEW THE FULL ISSUE

• Increase your facility's access to healthcare while improving the bottom line

  When Joel F. Karman, MSW, LSW, MPH, senior director of social services and guest relations at the...

• How one facility's brief assessment tool improved practice, productivity, and patient care

  Until January 2007, the University of North Carolina (UNC) Health Care System in Chapel Hill was...

• Bridge the gap between RNs and social workers to create a cohesive case management program

  For patients to receive the right care and to deal with the effect that an injury or health problem...

Issue 6, June 1, 2008 - VIEW THE FULL ISSUE

• Steps for starting an ED case management program

  Having a case management program in the ED can help alleviate capacity issues, ensure CMS...

• Technology helps case managers avoid burnout

  With so many case management departments understaffed and underfunded, many case managers around...

• Case managers can make a difference in improved coding

  Although many think a case manager's job includes utilization, resource management, and...

Issue 5, May 1, 2008 - VIEW THE FULL ISSUE

• Setting up a charity care team can save your hospital money in the long run

  There's no getting around the fact that the number of uninsured and underinsured patients raises...

• Massachusetts hospital finding way to help repeat substance abusers in the ED

  Substance abuse is a chronic illness just like congestive heart failure or diabetes, but it...

• Revised ABN should cause less confusion for patients

  On March 3, CMS released the new ABN. This form, also known as the ABN-R-131, will be used for all...

Issue 4, April 1, 2008 - VIEW THE FULL ISSUE

• LTACHs can help control patients' LOS

  Case managers with patients facing an LOS that is longer than expected or above the DRG geometric...

• Communication: A main factor in reducing readmissions

  In most cases, a hospital's goal is to improve a patient's health and eventually discharge him or...

• Save money and time by developing a collaborative case management program

  In the January Director's Desk feature of Case Management Monthly, Sharon Mass, PhD, ACM, a...

Issue 3, March 1, 2008 - VIEW THE FULL ISSUE

• Retaining case managers starts with the right interview process

  With so many hospitals running understaffed on a near constant basis, case managers are always in...

• Pilot study shows benefits of case management intervention for patients in physician practices

  The theory was that an efficient nurse case manager and an invested primary care physician (PCP...

• MS-DRG system makes complete documentation essential for maximum reimbursement and minimum denials

  The idea behind CMS' Medicare Severity DRG (MS-DRG) was to financially reward hospitals that treat...

• Physician querying is a must for accurate charting

  The best way for your hospital's documentation to be accurate is for physicians to take their time...

Issue 2, February 1, 2008 - VIEW THE FULL ISSUE

• Leveraging the role of the physician advisor

  Breaking down the responsibilities of physician advisors and helping them determine the best course...

• Complex case: Advance directives and the Surrogate Health Care Act

  Editor's note: This month's case study is an extended look at how case managers must understand...

• Disease management program cuts readmission days

  An advanced practice nursing program with a disease management component has been shown to reduce...

• Celebrate our heroes: Case management should focus on its stars and its stories

  Editor's note: As a follow-up to last month's conversation with Sharon Mass, PhD, ACM, this month's...

Issue 1, January 1, 2008 - VIEW THE FULL ISSUE

• Finding the appropriate level of care for extended LOS patients

  Case managers have to continually learn, maintain, and update a large body of knowledge and skill...

• Break the cycle and start 2008 the right way

  Your New Year's resolutions may have included things like "spend more time with the kids" or "lose...

• Collaborative practice is the future of case management

  Editor's note: To kick-start 2008, the first From the Director's Desk of the year is a special...