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Each year, CMSA pays special tribute to those individuals who have demonstrated distinguished service to the case management profession.
A primary goal of the awards program is to inform members of the case management profession, other health professionals, government officials, and the public of the outstanding accomplishments and significant achievements of individual case managers in the delivery of healthcare. In addition, the awards program assists the public in gaining a better understanding of the role of case management and its significant contribution to the delivery of healthcare. Award recipients are recognized each year during the association's annual conference. Explore our prestigious awards at the link below and start thinking about who you could nominate. The nomination deadline is February 28 or March 15, depending on the award. Visit http://www.cmsa.org/Individual/MemberToolkit/AwardsRecognition/tabid/184/Default.aspx to view the full article online. |
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Earn up to 2.0 contact hours at no fee This white paper, developed in partnership between CMSA, NTOCC and PRIME Education, focuses on transitions of care experienced by patients with idiopathic pulmonary fibrosis (IPF) between settings of care, including primary care, specialty care, IPF centers, acute care settings, long-term care and skilled nursing facilities, other post-acute care sites, and the patient’s home. Designed for healthcare professionals across the care continuum, the purpose of this guide is to outline pathways to: -Break down barriers to smooth care transitions-Improve education and awareness -Enhance efficient and accurate bi-directional transfer of essential patient health information -Equip patients and families/caregivers for self-management and advocacy Download the activity by clicking here. |
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Did your most recent continuing education experience explore how mobile is changing case management? Did you become more knowledgeable about post-acute care and the evolution of end of life care? We have you covered in those areas and more at CMSA's 27th Annual Conference & Expo in Austin, TX. We’ve just posted detailed information about the educational material which will be covered at this summer’s conference, and we think you’ll be interested in attending this year's unique sessions. Learn more and register today; early bird rates end March 31!
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CMSA Today|
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Download CMSA's Standards of Practice for Case Management, 2016 revision, which provides practice guidelines for the case management industry and its diverse stakeholders. The impetus for the 2016 revision of the Standards is the need to emphasize the professional nature of the practice and role of the case manager.
The 2016 Standards of Practice contain information about case management including an updated definition, practice settings, roles and responsibilities, case management process, philosophy and guiding principles, as well as the standards and how they are demonstrated. Visit https://www.naylornetwork.com/cmsapulse/articles/index-v3.asp?aid=423975&issueID=53658 to view the full article online. |
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Pat Stricker, RN, MEd
Senior Vice President, TCS Healthcare Technologies I recently found a detailed paper entitled, Case Management: What It Is and How It Can Best Be Implemented, written in 2011, that describes case management in the National Health System (NHS) in the United Kingdom (U.K.). One of the key recommendations was to implement well-targeted, effective, collaborative, community-oriented case management programs to meet the complex needs of patients with long-term conditions, as part of a wider strategy for integrated care. The paper was an interesting and thorough overview of case management in the U.K. It demonstrated that even though we have very different healthcare systems, we have similar processes, opportunities and challenges. I would highly recommend reading this, if you get a chance. The article was particularly interesting to me, since I worked on a consulting project in Northern England about 15 years ago to see if and how U.S. case management (CM) processes could be implemented in the National Health System (NHS) to facilitate, coordinate, and prioritize care. The goals of our project were to identify ways to improve the timeliness of care throughout the system, identify potential alternate levels of care that could be developed and used to free up inpatient beds, assure patient and provider satisfaction with the new changes, and improve outcomes. Care management processes and evidence-based guidelines were customized to assure they would work in the U.K. system. The project was very successful and a great learning experience for me, as I got an inside look at the NHS and how it compared with our healthcare system. Visit https://www.naylornetwork.com/cmsapulse/articles/index-v3.asp?aid=423976&issueID=53658 to view the full article online. |
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The Centers for Medicare & Medicaid Services (CMS) on February 15 issued a proposed rule for 2018, which proposes new reforms that are critical to stabilizing the individual and small group health insurance markets to help protect patients. This proposed rule would make changes to special enrollment periods, the annual open enrollment period, guaranteed availability, network adequacy rules, essential community providers, and actuarial value requirements; and announces upcoming changes to the qualified health plan certification timeline.
"Americans participating in the individual health insurance markets deserve as many health insurance options as possible," said Dr. Patrick Conway, Acting Administrator of the Centers for Medicare & Medicaid Services. "This proposal will take steps to stabilize the Marketplace, provide more flexibility to states and insurers, and give patients access to more coverage options. They will help protect Americans enrolled in the individual and small group health insurance markets while future reforms are being debated." Source: Centers for Medicare & Medicaid Services Visit https://www.cms.gov/Newsroom/MediaReleaseDatabase/Press-releases/2017-Press-releases-items/2017-02-15.html to view the full article online. |
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by Tammie Phillips, RN
Hospitals everywhere are striving to answer this question: How can we better manage denials? There’s tremendous pressure to reduce denials. According to the Centers for Medicare & Medicaid Services (CMS), 10 percent of CMS claims are denied,1 and Medicaid’s average denial rate is more than 18 percent.2 The American Medical Association found payers return up to 29 percent of claim lines with $0 for payment, while an MGMA study found more than half of denied claims are never reimbursed.3 The problem is worsening as claims processing complexity intensifies. Our population is aging, care needs are increasing, Medicare enrollment is rising, and comorbidities and chronic conditions are more prevalent. Population health management is also taking hold. Health systems are transitioning more patients across multiple settings and specialists, requiring multiple claims. Visit http://www.nxtbook.com/naylor/CMSQ/CMSQ0416/index.php?startid=10 to view the full article online. |
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As you likely know, the Case Management Society of America (CMSA) — the world's largest and most influential professional case management organization— works to provide case/care managers, social workers and other healthcare practitioners across the care continuum with resources to be more efficient, effective and competitive.
However, did you know that over the past 25 years, CMSA has done important industry work such as developing the Standards of Practice for Case Management and working on title protection for case management? If you already know these facts, you are probably already an official member of CMSA's growing and diverse community. If not, we'd love to provide you with additional resources to help you achieve your professional goals. Visit http://solutions.cmsa.org/acton/media/10442/cmsatoday-mar2016 to view the full article online. |
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The 2nd World Congress Summit on Managed Long Term Services and Support |
CMSA members