Description:-

The world of healthcare is changing rapidly, and so is the role of case management in that world!  The federal fiscal year 2019 promises to bring new and exciting changes that will impact your work as a case management professional. Whether you are reading or hearing about value-based reimbursement, the Affordable Care Act, the continuum of care, bundled payments, transitions in care, or accountable care organizations, case management is at the center of it all!

Because things are changing so rapidly, it can be a challenge to stay current and knowledgeable in the issues that most greatly impact your role as a case manager.  Each year we bring you the latest and greatest in the field of acute care case management.  We hope to do the same for you again this year!  Reimbursement has changed dramatically as has utilization management, transitional planning, and compliance. CMS has incorporated changes that impact on payments related to readmissions, length of stay and the cost of care.  And who is in a better place to address these issues than case managers!  Finally, how do you measure your impact on the cost and quality of care and the reimbursement your organization receives for that care? 

All these topics and more will be covered in this jam-packed five-part series.  The program will start with an overview of state of the art in case management today, how we got here, and where we are going in the future including a review of acute care reimbursement.  From there we will discuss the often-confusing subject of all the roles that occur in best practice departments.  

You will learn more about the complimentary, but separate roles of RN case managers and social work case managers.  From there, we will address best practice case management department models.  We will then review what utilization management and transitional planning really mean under the current CMS rules and the new CMS proposed rules. We will end our series with a discussion on the best ways to measure the outcomes of your case management department and its impact on the organization.

Whether you are new to case management or a seasoned pro, this webinar series will provide you with the latest and most up-to-date topics and information that you will need to be at the top of your game and produce the best outcomes for you, your patients and your organization.

Part 1: A Primer in Acute Care Reimbursement: From DRGs to Bundled Payments       

Feb 28, 2019    1:00 PM EST   90 Minutes

This program will provide a foundation of knowledge and understanding of the DRG system used as the structure for reimbursement under the Medicare and Medicaid programs. Included in this will be a review of the DRG relative weights, case mix index and expected lengths of stay. Medical record coding will be explained in the context of how hospitals get reimbursed. 

Description:-

Case management is truly the center of the universe, not only acute care hospitals, but for many of the levels of care across the post-acute care continuum.  Having a foundation for effective case management is critical, but likewise, having a foundation for the more complex processes of case management has become vital.  Challenges exist for RN case managers, social work case managers, case management leaders, and physicians, as they traverse this shaky world of constantly changing reimbursement, updated rules and regulations and strategic process improvement to align with any hospital’s need to meet their targeted outcomes.

Because things are changing so rapidly it can be a challenge to stay current and knowledgeable in the issues that most greatly impact your role as a case manager or a case management leader.  What are the best practice processes for coordinating care, ensuring compliance to rules and regulations, collaborating with physicians, and transitioning your patient through the care continuum to post-acute care case managers?

Finally, how do case managers remain integrated across the continuum?

All these topics and more will be covered in this jam-packed five-part series.  The program will start with a focus on care coordination, with a focus on the key stakeholders that can impact, both positively and negatively, you care coordination outcomes.  We will then review best practices for transitioning patients across the continuum.  From there we will discuss the often-challenging subject of how to best collaborate with physicians, especially your high-volume physicians, such as hospitalists and ED physicians.  As important as your high-volume physicians are, your physician advisors are essential to support optimal case management processes.  We will review not only the basics of compliance to rules and regulations, but also learn some of the most recent changes to compliance expectations—from, CMS, your state, and your payer contracts.  Finally, we will discuss how you can establish best practices to align with the community, those case managers in the post-acute care provider world, to whom you will be handing off your patients for their next moves through their health care continuum.

This webinar series will provide you with the latest and most up-to-date topics and information that you will need to be at the top of your game and produce the best outcomes for you, your patients and your organization.  It also gives you a higher level of case management practice as you continue your journey to become a more effective RN case manager, social work case manager, case management leader, or physician leader.

Part 1: Care Coordination: A Fundamental Case Management Roll for Managing Cost and Length of Stay

Apr 11, 2019    1:00 PM EST   90 Minutes

This program will review the elements that most greatly impact on cost and length of stay by focusing on care coordination as one of the key strategies for successful reductions of these metrics.   Care coordination, as one of the main roles of the RN case manager and social worker, is complex and includes many characteristics that encompass the role. These will be covered as well as those elements that have the greatest negative impact on care coordination. Those that have the greatest positive impact will be discussed in detail. 

Part 2: Transitions in Care: Best Practice Strategies for Aligning Acute and Post-Acute Providers

Apr 18, 2019    1:00 PM EST   90 Minutes

This program will review the concepts associated with the continuum of care in the new world of Accountable Care Organizations, value-based purchasing and bundled payments. In addition, we will review how to engage other members of the interdisciplinary care team in the process of planning for the patient’s movement across the continuum including verbal and written hand-off communication. Transitional planning is no longer a destination but a process! 

Part 3: Physician and Case Management Collaboration: Aligning with Hospitalists, Physician Advisors, ED Physicians and Other Key Stakeholders

May 01, 2019    1:00 PM EST   90 Minutes

Physicians are key in case management departments with optimal outcomes.  Certainly, the key physician roles are the physician advisor and the hospitalist.  This webinar will focus on these two roles specifically, as well as the roles of high volume admitters in general.

The role of the physician advisor in hospital case management is a varied role.  Not every hospital has an internal physician advisor.  If a hospital does not have an internal physician advisor, it usually has an external physician advisor.  Rarely are physicians prepared to this role.  Additionally, rarely are case managers or case management leaders prepared for implementing and/or collaborating with physicians in this role.  The collaborative role of the physician advisor and those in the case management department is one of the lynchpins to assist the department and practicing physicians to positively impact hospital outcomes. 

Part 4: Managing Case Management Compliance: Important Tools for Case Managers, Case Management Leaders and Physicians

May 14, 2019    1:00 PM EST   90 Minutes

This program will review the compliance issues that most greatly impact your practice such as the 2-midnight Rule, the NOTICE Act, HINNs, The Important Message and others. The Joint Commission is now monitoring these issues when they have deemed status from Medicare, so your compliance is critical to a good Joint Commission survey outcome.  This program will help you to identify where you may have compliance practice gaps as well as how to fix them!

Part 5: Case Management Across the Continuum: Acute Care and Community Case Management Finally Meet!

May 21, 2019    1:00 PM EST   90 Minutes

In this program you will learn how to coordinate  the patient’s transition between  healthcare systems and settings such as moving from the hospital to rehabilitation and home settings. We will discuss ways in which to maintain open communciation between the patient, patient’s family or cargiver and other members of the interdisciplinary healthcare team at all times regarding the transitional location.

There will be a disucssion on how to apply strategies for involving the patient and family in decisions regarding care and transitional options.

Finally we will review best practice strategies for ensuring that patients do not fall between  the many cracks and  gaps in today’s healthcare systems

Who Should Attend?

• Director of Case Management
• Director of Finance
• Case Managers
• Social Workers
• Vice President of Case Management
• Directors of Patient Centered Medical Homes
• Home Care Directors and Managers
• Home Care Case Managers
• Community-Based Providers
• Long-Term Care providers
• Community-Based providers
• Community-Based  Case Managers and Social Workers