Centers for Medicare and Medicaid Services (CMS)
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ACO’s Comprehensive Patient Navigation Can Reduce Costs, Increase Satisfaction
Surprisingly, accountable care organization enrollees who are given fewer choices but better navigation assistance in making decisions are happier with their healthcare access, researchers found.
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Case Managers Can Better Educate Patients and Families About Opioid Addiction
While the world focused on the COVID-19 pandemic, another crisis — the opioid epidemic — continued to unfold, taking hundreds of thousands of lives. Hospital discharge is an opportunity for case managers and other providers to help prevent patients from becoming victims of opioid overdoses.
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Best Practices for Maternity Case Management
In many ways, case management in the maternity and labor/delivery units is unlike other areas of the hospital. Often, the mothers and babies are healthy, and simply in need of support through the process. For that reason, it may even seem that case management is unnecessary. However, it is important to maintain a strong case management department that serves in labor and delivery as well as the postpartum units.
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Understanding Bundled Payments
Bundled payments can be confusing for case managers to navigate. The philosophy behind the bundled payment reimbursement model is that in managing the patient carefully across the continuum, transitions will be smoother and the care will improve, all while staying mindful of how the dollars are spent. It is meant to be a meeting of quality of care and cost-effectiveness.
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The Role of Critical Access Hospitals
In rural areas, critical access hospitals provide care to patients who otherwise would have to travel much further for adequate care. Serving in a critical access hospital can be a much different experience than a larger hospital system, or even a hospital in an urban or suburban environment. Due to lack of training and support, even the case management process might not be as seamless or efficient as it is in other settings.
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States: End HCW COVID-19 Vaccine Mandates
Twenty-two states have joined to petition CMS to stop mandating COVID-19 vaccines for healthcare workers. In a Nov. 18, 2022, letter to HHS Secretary Xavier Becerra, West Virginia Attorney General Patrick Morrisey called for the vaccination requirement to be withdrawn.
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Care Managers Help Improve Birth Outcomes with Prenatal Coordination
Recent research shows a prenatal care initiative, called Strong Start for Mothers and Newborns, can produce positive health results. The program works with Medicaid beneficiaries in more than 30 states through maternity care homes.
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Build a Healthy Relationship with Insurance Providers
It can be a tense relationship. Healthcare systems and providers — including case managers — have admitted it sometimes feels like insurance is the enemy, and patients have been known to carry that same sentiment. How should case managers and other healthcare professionals work out a healthy connection with insurance companies, and even work to strengthen that connection to help build a more positive view of the relationship among healthcare, insurance, and the patient?
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Better Recruitment Can Improve Safety During Staff Shortages
As staff shortages threaten patient safety, hospitals and health systems are eager to bring more clinicians on board. But this is becoming harder, especially for the most desired candidates. Improving the application and hiring process can improve patient safety.
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Updates to CMS Outpatient Rules
In July, CMS issued proposed rules that could raise Medicare Outpatient Prospective Payment System rates in 2023.