Description:-

Integrating case management across the continuum requires that hospitals and post-acute providers think like an Accountable Care Organization even if they aren’t one.  This kind of thinking requires that patients remain the center of the wheel around which all case management processes revolve.  Every case management department must ensure that they are providing an infrastructure for managing patients across the continuum that includes hard-wired processes for identifying and managing the highest risk patients regardless of setting.

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.

Since many factors impact on the integration of case management among and between  providers these will be covered in detail including the role of the patient/family, physicians  and other providers of care, case management and post-acute providers.

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

Learning Objectives:-

• Understand how case management is applied in different settings across the continuum.
• Discuss the vital role of case management in coordinating care across the continuum.
• Identify strategies for eliminating barriers affecting care transitions.

Course Outline:-

• Case management as a strategy for linking patients across the continuum.
• A contemporary desciption of the continuum of care.
• Applications of case management regardless of setting.
• How to engage stakeholders in patient care transitions.
• The three components of care transitions.
• The influnences on patient care transitions.
• Internal and external solutions to care transitions.
• Developing an ACO mentality.
• A review of community case management

Why You Should Attend?

While some hospitals are participating with the Centers for Medicare and Medicaid Services (CMS) as an accountable care organization (ACO), others are not yet participating. Even if your hospital or health system is currently not participating, many of the new CMS initiatives and payment changes still require that you think and behave like one.  Bundled payments are one such example in which quality of care and costs must be managed across the continuum.  Evidence shows us that case management can serve as the lynch pin that connects departments and disciplines across the continuum while retaining the patient as the center figure in the process.  This program provides the attendee with concrete and implementable strategies for integrating and embedding case management across the continuum of care.

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