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Monday, February 24, 2014
  Clinical Accuracy Spoken Here  

CM Express: Accelerating the New CM

To accelerate your performance as a (new) CM you must be proactive. How?

  • Invest the time to make conscious choices and follow through on them
  • Make a conscious effort to control situations before the situation controls the patient's outcome
  • Consciously engineer events to prevent delays in services, treatments and care transitions
  • Assess the individual situation
  • Anticipate barriers to patient care and care transitions
  • Develop a coordinated plan to prevent delays with the interdisciplinary team

[Reference: CM Express, Mod A, Accelerating Your Performance]

  Excellence in Case Mgmt  

CM Express: Defining HC Value

Value in industry is defined as residing at the intersection of a purchasers' perception of a good or service and the amount they are willing to spend for it. Thus value is increased by improved quality, a reduction in amount paid or both.

In health care this measure has remained elusive. Value is driving a fundamental reorientation of the healthcare system around the quality and cost-effectiveness of care. Value in health care is defined through the relationship of:

  • Quality of care
  • Price paid for the care
Virtually all healthcare organizations are working to clarify and communicate their value proposition.

[Reference: CM Express, Mod C, Effective Resource Management]

  Improving Patient Care...  

CM Express: Avoiding Readmissions

Identifying and reducing avoidable readmissions will:

  • Improve patient safety
  • Enhance quality of care
  • Lower healthcare spending

In the arena of acute hospital care, the focus of discharge planning and transitions of care is to prevent unplanned readmissions which are related to the initial stay.

On October 1, 2014 CMS will launch the third phase of the HRRP, raising the maximum penalty to 3% and expanding the number of conditions for which readmissions are penalized to include chronic obstructive pulmonary disease (COPD) and elective hip and knee replacements.

[Reference: CM Express, Mod D, Enhanced Care Transitions]


Tom RasmussenTom Rasmussen
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