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| chronic care management company: The Role of Telehealth in an Evolving Health Care Environment Institute of Medicine, Board on Health Care Services, 2012-11-20 In 1996, the Institute of Medicine (IOM) released its report Telemedicine: A Guide to Assessing Telecommunications for Health Care. In that report, the IOM Committee on Evaluating Clinical Applications of Telemedicine found telemedicine is similar in most respects to other technologies for which better evidence of effectiveness is also being demanded. Telemedicine, however, has some special characteristics-shared with information technologies generally-that warrant particular notice from evaluators and decision makers. Since that time, attention to telehealth has continued to grow in both the public and private sectors. Peer-reviewed journals and professional societies are devoted to telehealth, the federal government provides grant funding to promote the use of telehealth, and the private technology industry continues to develop new applications for telehealth. However, barriers remain to the use of telehealth modalities, including issues related to reimbursement, licensure, workforce, and costs. Also, some areas of telehealth have developed a stronger evidence base than others. The Health Resources and Service Administration (HRSA) sponsored the IOM in holding a workshop in Washington, DC, on August 8-9 2012, to examine how the use of telehealth technology can fit into the U.S. health care system. HRSA asked the IOM to focus on the potential for telehealth to serve geographically isolated individuals and extend the reach of scarce resources while also emphasizing the quality and value in the delivery of health care services. This workshop summary discusses the evolution of telehealth since 1996, including the increasing role of the private sector, policies that have promoted or delayed the use of telehealth, and consumer acceptance of telehealth. The Role of Telehealth in an Evolving Health Care Environment: Workshop Summary discusses the current evidence base for telehealth, including available data and gaps in data; discuss how technological developments, including mobile telehealth, electronic intensive care units, remote monitoring, social networking, and wearable devices, in conjunction with the push for electronic health records, is changing the delivery of health care in rural and urban environments. This report also summarizes actions that the U.S. Department of Health and Human Services (HHS) can undertake to further the use of telehealth to improve health care outcomes while controlling costs in the current health care environment. |
| chronic care management company: Health Professions Education Institute of Medicine, Board on Health Care Services, Committee on the Health Professions Education Summit, 2003-07-01 The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system. |
| chronic care management company: Living a Healthy Life with Chronic Conditions Kate Lorig, 2000 Drawing on input from people with long-term ailments, this book points the way to achieving the best possible life under the circumstances. |
| chronic care management company: Medicare Chronic Care Improvement Program United States. Congress. House. Committee on Ways and Means. Subcommittee on Health, 2005 |
| chronic care management company: The Future of the Public's Health in the 21st Century Institute of Medicine, Board on Health Promotion and Disease Prevention, Committee on Assuring the Health of the Public in the 21st Century, 2003-02-01 The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists. |
| chronic care management company: Health Care Information Systems Karen A. Wager, Frances W. Lee, John P. Glaser, 2017-02-08 BESTSELLING GUIDE, UPDATED WITH A NEW INFORMATION FOR TODAY'S HEALTH CARE ENVIRONMENT Health Care Information Systems is the newest version of the acclaimed text that offers the fundamental knowledge and tools needed to manage information and information resources effectively within a wide variety of health care organizations. It reviews the major environmental forces that shape the national health information landscape and offers guidance on the implementation, evaluation, and management of health care information systems. It also reviews relevant laws, regulations, and standards and explores the most pressing issues pertinent to senior level managers. It covers: Proven strategies for successfully acquiring and implementing health information systems. Efficient methods for assessing the value of a system. Changes in payment reform initiatives. New information on the role of information systems in managing in population health. A wealth of updated case studies of organizations experiencing management-related system challenges. |
| chronic care management company: Individualized Care Riitta Suhonen, Minna Stolt, Evridiki Papastavrou, 2018-08-22 This contributed book is based on more than 20 years of researches on patient individuality, care and services of the continuously changing healthcare system. It describes how research results can be used to respond to challenges on individuality in healthcare systems. Service users’, patients’ or clients’ point of views on care and health services are urgently needed. This book describes the conceptualisation of the individualized nursing care phenomenon and the process development of the measuring instruments of that phenomenon in different contexts. It describes results from a variety of clinical contexts about individualized nursing care and explains factors associated with the perceptions and delivery of individualized nursing care from different point of views. This book may appeal to clinicians, nurses practitioners and researchers from many fields. |
| chronic care management company: Eliminating Barriers to Chronic Care Management in Medicare United States. Congress. House. Committee on Ways and Means. Subcommittee on Health, 2003 |
| chronic care management company: Long-Term Care Administration and Management Darlene Yee-Melichar, EdD, Cristina M. Flores, Edwin P. Cabigao, 2014-02-07 Print+CourseSmart |
| chronic care management company: Assessing Chronic Disease Management in European Health Systems World Health Organization, 2015-12-16 This publication explores some of the key issues, ranging from interpreting the evidence base to assessing the policy context for, and approaches to, chronic disease management across Europe. Drawing on 12 detailed country reports (available in a second, online volume), the study provides insights into the range of care models and the people involved in delivering these; payment mechanisms and service user access; and challenges faced by countries in the implementation and evaluation of these novel approaches. |
| chronic care management company: Care Without Coverage Institute of Medicine, Board on Health Care Services, Committee on the Consequences of Uninsurance, 2002-06-20 Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash. |
| chronic care management company: Case Management Suzanne K. Powell, Hussein M. Tahan, 2018-02-26 Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management |
| chronic care management company: CMSA's Integrated Case Management Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN, Rebecca Perez, MSN, RN, CCM, FCM, Corine Latour, PhD, RN, 2018-01-28 Written by case managers for case managers, this reference manual for nurses and other health professionals presents a CMSA tested approach towards systematically integrating physical and mental health case management principles and assessment tools. Since the health care field has undergone major changes such as the passing of the Patient Protection and Affordable Care Act, Mental Health Parity, Transition of Care & Chronic Care Management and the Medicare Act and CHIP Authorization Act (MACRA), health care workers must competently know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice. CMSA’s Integrated Case Management delves into the role of the case manager and unpacks how case managers assess and treat complex patients. These are patients who may be challenged with medical and behavioral conditions, poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, digital and telemedicine, and new performance measures that are clearly defined for nurses in nursing terminology, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach. All content aligns with the newly revised 2017 Model Care Act, CMSA Standards of Practice 2016 as well as the CMSA Core Curriculum for Case Management Third Edition. |
| chronic care management company: Patient Safety and Quality Ronda Hughes, 2008 Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043). - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/ |
| chronic care management company: The Medicare Handbook , 1988 |
| chronic care management company: CMSA’s Integrated Case Management Rebecca Perez, MSN, RN, CCM, FCM, 2023-09-15 Developed by the Case Management Society of America (CMSA), this manual provides case managers with the essential tools necessary to successfully support quality patient care within today's complex healthcare system. This updated and revised second edition addresses the role of the case manager and unpacks how to assess and treat patients with complex issues; including those who are challenged with medical and behavioural conditions and poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, and new performance measures, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach. Written by case managers for case managers, this practical manual presents the CMSA--tested approach toward systematically integrating physical and mental health case management principles and assessment tools. As the healthcare field continues to increase in complexity and given the constantly changing regulatory environment, healthcare workers must know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice. New to This Edition: Increased coverage and focus on Social Determinants of Health New chapters on support specialty populations including veterans, trauma survivors, maternal child health, children with special healthcare needs Simplified terminology and presentation of CMSA Assessment Grid and process Key Features Aligned with the Model Care Act, the CMSA Standards of Practice, and the CMSA Core Curriculum for Case Management Assists case managers enhance their ability to work with complex patients and learn how to apply new evidence-based assessments, as it fosters safe and high-quality care Teaches case managers to evaluate patients for medical and mental health barriers in order to coordinate appropriate integrated interventions and treatment planning Integrates biological, psychological, social and health system assessment Supports care of adult, elderly, and pediatric patient populations with complex issues |
| chronic care management company: Purchasing for Quality Chronic Care Summary Report OECD, World Health Organization, 2023-10-16 The publication builds on the existing body of empirical evidence and newly commissioned case studies from Australia, Canada, Chile, China, Germany, Indonesia, South Africa, and Spain to better understand the design of different purchasing arrangements that aim to promote quality for chronic disease care. |
| chronic care management company: Retooling for an Aging America Institute of Medicine, Board on Health Care Services, Committee on the Future Health Care Workforce for Older Americans, 2008-08-27 As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs. |
| chronic care management company: Best Care at Lower Cost Institute of Medicine, Committee on the Learning Health Care System in America, 2013-05-10 America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost. The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009-roughly $750 billion-was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances. About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care. This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions. |
| chronic care management company: Promoting disease management in Medicare United States. Congress. House. Committee on Ways and Means. Subcommittee on Health, 2002 |
| chronic care management company: From Coverage to Care Enrollment Toolkit Centers for Medicare & Medicaid Services (U.S.), 2015 This toolkit is for community partners, assisters, and other people who help consumers enroll in coverage or change their plan.' |
| chronic care management company: Leadership and Nursing Care Management Diane Huber, 2013-09-24 Research Notes in each chapter summarize relevant nursing leadership and management studies and show how research findings can be applied in practice. Leadership and Management Behavior boxes in each chapter highlight the performance and conduct expected of nurse leaders, managers, and executives. Leading and Managing Defined boxes in each chapter list key terminology related to leadership and management, and their definitions. Case Studies at the end of each chapter present real-world leadership and management situations and illustrate how key chapter concepts can be applied to actual practice. Critical Thinking Questions at the end of each chapter present clinical situations followed by critical thinking questions that allow you to reflect on chapter content, critically analyze the information, and apply it to the situation.A new Patient Acuity chapter uses evidence-based tools to discuss how patient acuity measurement can be done in ways that are specific to nursing. A reader-friendly format breaks key content into easy-to-scan bulleted lists. Chapters are divided according to the AONE competencies for nurse leaders, managers, and executives. Practical Tips boxes highlight useful strategies for applying leadership and management skills to practice. |
| chronic care management company: Guided Care Chad Boult, MD, MPH, Jean Giddens, PhD, RN, Katherine Frey, MPH, Lisa Reider, MHS, Tracy Novak, MHS, 2009-02-26 Winner of the 2009 Medical Economics Award! Boult and his colleagues . . . . have crafted a team model that builds upon the unique strengths of nurses and primary care physicians coupled with effective communication and implementation of evidence-based care. This represents a great advance over business as usual. --David B. Reuben, MD Director, Multicampus Program in Geriatric Medicine and Gerontology Chief, Division of Geriatrics David Geffen School of Medicine at UCLA Guided Care is an exciting, new team model used to provide medical care to clients with chronic conditions. This model involves adding a Guided Care nurse to the primary care practice team. It is also the most efficient, cost-effective way to respond to the needs of patients. This book provides physicians, nurses, administrators, and leaders of health care organizations with step-by-step guidance on adopting Guided Care Nursing into their practice. Featured Highlights: Evaluating the primary care pratice's readiness to adopt Guided Care Preparing for adoption Integrating Guided Care into existing practices Hiring nurses for the primary care team Assuring financial viability Comparing Guided Care with other models The future of primary care, and the quality of care for adults with chronic conditions, depends on finding approaches to improve efficiency and effectiveness. This book demonstrates that Guided Care yields the best outcomes for patients and for primary care at large. |
| chronic care management company: Promoting Self-Management of Chronic Health Conditions Erin Martz, 2017-08-15 Promoting Self-Management of Chronic Health Conditions covers a range of topics related to self-management-theories and practice, interventions that have been scientifically tested, and information that individuals with specific conditions should know (or be taught by healthcare professionals). |
| chronic care management company: Disease Management Warren E. Todd, David B. Nash, MD, 2001-01-22 Motivated by business pressures, market consolidation, and the pursuit of quality care, health care professionals in all areas of practice are beginning to explore more fully the tremendous potential of disease management-- a systemwide strategy for proactively managing chronic diseases across the entire continuum of care. Disease Management is the first book to bring together systems thinking and organizational structure in a framework for designing, developing, and implementing a comprehensive health management system. |
| chronic care management company: Essential Readings in Case Management Catherine M. Mullahy, 1998 Bullets in Emergency Medicine: Review and Reminders in Pursuit of Evidence-Based Decisions is a concise guide to the diagnosis and treatment patients in the Emergency Department. Arranged by signs and symptoms as well as by system, this accessible handbook is an ideal reference for use in the Emergency Department and a perfect review for the ACEP boards. |
| chronic care management company: Evidence-Based Physical Examination Kate Sustersic Gawlik, DNP, APRN-CNP, FAANP, Bernadette Mazurek Melnyk, PhD, APRN-CNP, FAANP, FNAP, FAAN, Alice M. Teall, DNP, APRN-CNP, FAANP, 2020-01-27 The first book to teach physical assessment techniques based on evidence and clinical relevance. Grounded in an empirical approach to history-taking and physical assessment techniques, this text for healthcare clinicians and students focuses on patient well-being and health promotion. It is based on an analysis of current evidence, up-to-date guidelines, and best-practice recommendations. It underscores the evidence, acceptability, and clinical relevance behind physical assessment techniques. Evidence-Based Physical Examination offers the unique perspective of teaching both a holistic and a scientific approach to assessment. Chapters are consistently structured for ease of use and include anatomy and physiology, key history questions and considerations, physical examination, laboratory considerations, imaging considerations, evidence-based practice recommendations, and differential diagnoses related to normal and abnormal findings. Case studies, clinical pearls, and key takeaways aid retention, while abundant illustrations, photographic images, and videos demonstrate history-taking and assessment techniques. Instructor resources include PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank. This is the physical assessment text of the future. Key Features: Delivers the evidence, acceptability, and clinical relevance behind history-taking and assessment techniques Eschews “traditional” techniques that do not demonstrate evidence-based reliability Focuses on the most current clinical guidelines and recommendations from resources such as the U.S. Preventive Services Task Force Focuses on the use of modern technology for assessment Aids retention through case studies, clinical pearls, and key takeaways Demonstrates techniques with abundant illustrations, photographic images, and videos Includes robust instructor resources: PowerPoint slides, a test bank with multiple-choice questions and essay questions, and an image bank Purchase includes digital access for use on most mobile devices or computers |
| chronic care management company: Living Well with Chronic Illness Institute of Medicine, Board on Population Health and Public Health Practice, Committee on Living Well with Chronic Disease: Public Health Action to Reduce Disability and Improve Functioning and Quality of Life, 2011-06-30 In the United States, chronic diseases currently account for 70 percent of all deaths, and close to 48 million Americans report a disability related to a chronic condition. Today, about one in four Americans have multiple diseases and the prevalence and burden of chronic disease in the elderly and racial/ethnic minorities are notably disproportionate. Chronic disease has now emerged as a major public health problem and it threatens not only population health, but our social and economic welfare. Living Well with Chronic Disease identifies the population-based public health actions that can help reduce disability and improve functioning and quality of life among individuals who are at risk of developing a chronic disease and those with one or more diseases. The book recommends that all major federally funded programmatic and research initiatives in health include an evaluation on health-related quality of life and functional status. Also, the book recommends increasing support for implementation research on how to disseminate effective longterm lifestyle interventions in community-based settings that improve living well with chronic disease. Living Well with Chronic Disease uses three frameworks and considers diseases such as heart disease and stroke, diabetes, depression, and respiratory problems. The book's recommendations will inform policy makers concerned with health reform in public- and private-sectors and also managers of communitybased and public-health intervention programs, private and public research funders, and patients living with one or more chronic conditions. |
| chronic care management company: Chaos and Organization in Health Care Thomas H. Lee, James J. Mongan, 2012-02-10 Two leading physicians' prescription for solving our health care problems: organizing the fragmented system that delivers care. One of the most daunting challenges facing the new U.S. administration is health care reform. The size of the system, the number of stakeholders, and ever-rising costs make the problem seem almost intractable. But in Chaos and Organization in Health Care, two leading physicians offer an optimistic prognosis. In their frontline work as providers, Thomas Lee and James Mongan see the inefficiency, the missed opportunities, and the occasional harm that can result from the current system. The root cause of these problems, they argue, is chaos in the delivery of care. If the problem is chaos, the solution is organization, and in this timely and outspoken book, they offer a plan. In many ways, this chaos is caused by something good: the dramatic progress in medical science—the explosion of medical knowledge and the exponential increase in treatment options. Imposed on a fragmented system of small practices and individual patients with multiple providers, progress results in chaos. Lee and Mongan argue that attacking this chaos is even more important than whether health care is managed by government or controlled by market forces. Some providers are already tightly organized, adapting management principles from business and offering care that is by many measures safer, better, and less costly. Lee and Mongan propose multiple strategies that can be adopted nationwide, including electronic medical records and information systems for sharing knowledge; team-based care, with doctors and other providers working together; and disease management programs to coordinate care for the sickest patients. |
| chronic care management company: CMSA Core Curriculum for Case Management Hussein M. Tahan, Teresa M. Treiger, 2016-07-05 The fully updated CMSA Core Curriculum for Case Management, 3rd edition, is the definitive roadmap to an informed, effective, collaborative case management practice. This comprehensive, expertly-written guide provides those directly or indirectly involved in case management with information about best practices, descriptions of key terms, essential skills, and tools that fulfill the current Case Management Society of America’s (CMSA) standards and requirements. Addressing the full spectrum of healthcare professional roles and environments, this is both a crucial certification study guide and vital clinical resource for the case management professionals in all specialty areas, from students to veteran case managers. This unique resource provides the core knowledge needed for safe, cost-effective case management with the following features ... NEW text boxes highlighting key information and vital practices in each chapter NEW and updated Standards of Practice implications in each chapter NEW and updated content on transitions of care, community-based care, care coordination, Value-Based Purchasing, ethics and social media, the impacts of health care reform, and digital technology NEW and updated content on accreditation in case management NEW chapter that lists key additional resources, by topic Official publication of the Case Management Society of America, connecting CMSA core curriculum to current CMSA Standards of Practice Easy-to-grasp, detailed topical outline format for quick scan of topics Complete, updated core knowledge required of case managers, with expert descriptions and direction on areas including: Case management roles, functions, tools, and processes Plans, clinical pathways, and use of technology Transitional planning Utilization management and resource management Leadership skills and concepts Quality and outcomes management; legal and ethical issues Education, training, and certification Health care insurance, benefits, and reimbursement systems Practice settings and throughput Interdisciplinary teams’ needs in: hospitals, community clinics, private practice, acute care, home care, long-term care and rehab settings, palliative care, and hospice settings Up-to-date guidance on case management specialty practices, including: nursing, life care planning, workers’ compensation, disability management, care of the elderly, behavioral health, transitions of care, subacute and long-term care, utilization review/management, primary care and medical/health home, and more Essential content for academic reference, training, certification study, case management models design, performance or program evaluation |
| chronic care management company: Chronic Disease Management, An Issue of Primary Care Clinics in Office Practice Brooke Salzman, Lauren Collins, Emily R Hajjar, 2012-06-28 This issue covers topics central to the management of the patient with a chronic disease by taking a comprehenisve look at: Successful/Innovative Models in Chronic Disease Management, The Patient-Centered Medical Home, Self-Management Education and Support, Major Pharmacologic Issues in Chronic Disease Management, Health Information Technology, Community-Based Partnerships for Improving Chronic Disease Management, and Effective Strategies for Behavioral Change, Diabetes Management, CHF Management, Asthma Management, and Depression Management. |
| chronic care management company: Prescription for the Future Ezekiel J. Emanuel, J Emanuel, 2017-06-06 How can America's healthcare system be transformed to provide consistently higher-quality and lower-cost care? Nothing else in healthcare matters more. Prescription for the Future identifies some standout medical organizations that have achieved higher-quality, more patient-focused, and lower-cost care, and from their examples distills twelve transformational practices that could transform the entire healthcare sector. Ezekiel J. Emanuel looks at individual physician practices and organizations who are already successfully driving change, and the specific practices they have instituted. They are not the titans everyone seems to know and assume to be the best; instead, Emanuel has chosen a select group -- from small physician offices to large multi-specialty group practices, accountable care organizations, and even for-profit companies--that are genuinely transforming care. Prescription for the Future shines a bright diagnostic light on the state of American healthcare and provides invaluable insights for healthcare workers, investors, and patients. The book gives all of us the tools to recognize the places that will deliver high-quality, effective care when we need it. |
| chronic care management company: Leadership and Nursing Care Management Diane Huber, 2010 This new edition addresses basic issues in nurse management such as law and ethics, staffing and scheduling, delegation, cultural considerations and management of time and stress. It also provides readers with the core concepts that separate adequate and exceptional nurse managers. |
| chronic care management company: Annual Review of Gerontology and Geriatrics, Volume 16, 1996 , 1996-11-15 The contributors to this volume provide an overview of each component of the acute and long-term care service continuum, including managed health care, subacute care, nursing homes, community care case management, and private case management. This volume is one of the first efforts to place these varied approaches side-by-side, highlighting the gaps and areas of duplication in the services delivery system. In addition, chapters address the emerging practices in long-term care financing and assisted living as well as the conceptual issues that need to be resolved to achieve acute and chronic care integration. This volume is of primary importance to professionals involved in long-term care, including administration, community nursing, social work, case management, discharge planning and policy. |
| chronic care management company: Registries for Evaluating Patient Outcomes Agency for Healthcare Research and Quality/AHRQ, 2014-04-01 This User’s Guide is intended to support the design, implementation, analysis, interpretation, and quality evaluation of registries created to increase understanding of patient outcomes. For the purposes of this guide, a patient registry is an organized system that uses observational study methods to collect uniform data (clinical and other) to evaluate specified outcomes for a population defined by a particular disease, condition, or exposure, and that serves one or more predetermined scientific, clinical, or policy purposes. A registry database is a file (or files) derived from the registry. Although registries can serve many purposes, this guide focuses on registries created for one or more of the following purposes: to describe the natural history of disease, to determine clinical effectiveness or cost-effectiveness of health care products and services, to measure or monitor safety and harm, and/or to measure quality of care. Registries are classified according to how their populations are defined. For example, product registries include patients who have been exposed to biopharmaceutical products or medical devices. Health services registries consist of patients who have had a common procedure, clinical encounter, or hospitalization. Disease or condition registries are defined by patients having the same diagnosis, such as cystic fibrosis or heart failure. The User’s Guide was created by researchers affiliated with AHRQ’s Effective Health Care Program, particularly those who participated in AHRQ’s DEcIDE (Developing Evidence to Inform Decisions About Effectiveness) program. Chapters were subject to multiple internal and external independent reviews. |
| chronic care management company: Buck's 2024 HCPCS Level II - E-Book Elsevier, 2024-01-03 - NEW! Updated HCPCS code set ensures fast and accurate coding, with the latest Healthcare Common Procedure Coding |
| chronic care management company: Engineering a Learning Healthcare System National Academy of Engineering, Institute of Medicine, 2011-07-14 Improving our nation's healthcare system is a challenge which, because of its scale and complexity, requires a creative approach and input from many different fields of expertise. Lessons from engineering have the potential to improve both the efficiency and quality of healthcare delivery. The fundamental notion of a high-performing healthcare system-one that increasingly is more effective, more efficient, safer, and higher quality-is rooted in continuous improvement principles that medicine shares with engineering. As part of its Learning Health System series of workshops, the Institute of Medicine's Roundtable on Value and Science-Driven Health Care and the National Academy of Engineering, hosted a workshop on lessons from systems and operations engineering that could be applied to health care. Building on previous work done in this area the workshop convened leading engineering practitioners, health professionals, and scholars to explore how the field might learn from and apply systems engineering principles in the design of a learning healthcare system. Engineering a Learning Healthcare System: A Look at the Future: Workshop Summary focuses on current major healthcare system challenges and what the field of engineering has to offer in the redesign of the system toward a learning healthcare system. |
| chronic care management company: Buck's 2023 HCPCS Level II - E-Book Elsevier, 2023-01-18 For fast, accurate, and efficient coding, pick this practical HCPCS reference! Buck's 2023 HCPCS Level II provides an easy-to-use guide to the latest HCPCS codes. It helps you locate specific codes, comply with coding regulations, manage reimbursement for medical supplies, report patient data, code Medicare cases, and more. Spiral bound, this full-color reference simplifies coding with anatomy plates (including Netter's Anatomy illustrations) and ASC (Ambulatory Surgical Center) payment and status indicators. In addition, it includes a companion website with the latest coding updates. - UNIQUE! Current Dental Terminology (CDT) codes from the American Dental Association (ADA) offer one-step access to all dental codes. - UNIQUE! Full-color anatomy plates (including Netter's Anatomy illustrations) enhance your understanding of specific coding situations by helping you understand anatomy and physiology. - Easy-to-use format optimizes reimbursement through quick, accurate, and efficient coding. - At-a-glance code listings and distinctive symbols make it easy to identify new, revised, and deleted codes. - Full-color design with color tables helps you locate and identify codes with speed and accuracy. - Jurisdiction symbols show the appropriate contractor to be billed when submitting claims to Medicare carriers and Medicare Administrative Contractors (MACs). - Ambulatory Surgery Center (ASC) payment and status indicators show which codes are payable in the Hospital Outpatient Prospective Payment System to ensure accurate reporting and appropriate reimbursement. - Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) indicators address reimbursement for durable medical equipment, prosthetics, orthotics, and supplies. - Drug code annotations identify brand-name drugs as well as drugs that appear on the National Drug Class (NDC) directory and other Food and Drug Administration (FDA) approved drugs. - Age/sex edits identify codes for use only with patients of a specific age or sex. - Quantity symbol indicates the maximum allowable units per day per patient in physician and outpatient hospital settings, as listed in the Medically Unlikely Edits (MUEs) for enhanced accuracy on claims. - The American Hospital Association Coding Clinic® for HCPCS citations provide a reference point for information about specific codes and their usage. - Physician Quality Reporting System icon identifies codes that are specific to PQRS measures. - NEW! Updated HCPCS code set ensures fast and accurate coding, with the latest Healthcare Common Procedure Coding |
| chronic care management company: Nursing Informatics for the Advanced Practice Nurse, Third Edition Susan McBride, PhD, RN-BC, CPHIMS, FAAN, Mari Tietze, PhD, RN, FHIMSS, FAAN, 2022-02-01 Winner of two first place AJN Book of the Year Awards! This award-winning resource uniquely integrates national goals with nursing practice to achieve safe, efficient quality of care through technology management. The heavily revised third edition emphasizes the importance of federal policy in digitally transforming the U.S. healthcare delivery system, addressing its evolution and current policy initiatives to engage consumers and promote interoperability of the IT infrastructure nationwide. It focuses on ways to optimize the massive U.S. investment in HIT infrastructure and examines usability, innovative methods of workflow redesign, and challenges with electronic clinical quality measures (eCQMs). Additionally, the text stresses documentation challenges that relate to usability issues with EHRs and sub-par adoption and implementation. The third edition also explores data science, secondary data analysis, and advanced analytic methods in greater depth, along with new information on robotics, artificial intelligence, and ethical considerations. Contributors include a broad array of notable health professionals, which reinforces the book's focus on interprofessionalism. Woven throughout are the themes of point-of-care applications, data management, and analytics, with an emphasis on the interprofessional team. Additionally, the text fosters an understanding of compensation regulations and factors. New to the Third Edition: Examines current policy initiatives to engage consumers and promote nationwide interoperability of the IT infrastructure Emphasizes usability, workflow redesign, and challenges with electronic clinical quality measures Covers emerging challenge proposed by CMS to incorporate social determinants of health Focuses on data science, secondary data analysis, citizen science, and advanced analytic methods Revised chapter on robotics with up-to-date content relating to the impact on nursing practice New information on artificial intelligence and ethical considerations New case studies and exercises to reinforce learning and specifics for managing public health during and after a pandemic COVID-19 pandemic-related lessons learned from data availability, data quality, and data use when trying to predict its impact on the health of communities Analytics that focus on health inequity and how to address it Expanded and more advanced coverage of interprofessional practice and education (IPE) Enhanced instructor package Key Features: Presents national standards and healthcare initiatives as a guiding structure throughout Advanced analytics is reflected in several chapters such as cybersecurity, genomics, robotics, and specifically exemplify how artificial intelligence (AI) and machine learning (ML) support related professional practice Addresses the new re-envisioned AACN essentials Includes chapter objectives, case studies, end-of-chapter exercises, and questions to reinforce understanding Aligned with QSEN graduate-level competencies and the expanded TIGER (Technology Informatics Guiding Education Reform) competencies. |
| chronic care management company: Integrating Care to Prevent and Manage Chronic Diseases Best Practices in Public Health OECD, 2023-05-10 People today are living longer with complex health needs but often receive fragmented care. This has prompted countries to support patient-centred, integrated care models. As part of OECD’s work on best practices in public health, this report outlines policy recommendations to prevent and manage chronic diseases by integrating care. Policy recommendations were drawn from a review of key integrated care models implemented in OECD and EU27 countries. |
MLN909188 Chronic Care Management Services - Centers …
CMS recognizes chronic care management (CCM) as a critical primary care service that contributes to better Medicare patient health and care. We pay for CCM services provided to …
Altysys _Chronic Care Management Model_Case study
Chronic disease management requires healthcare providers to closely monitor and support patients over extended periods. Clinics handling patients with conditions such as diabetes and …
Chronic Care Management
ChartSpan provides a fully-managed Chronic Care Management (CCM) program designed specifically for your practice. ChartSpan handles all moving parts of CCM for you. From …
WHAT IS CHRONIC CARE MANAGEMENT? - Centers for …
If you have Medicare or are dually eligible (Medicare and Medicaid) and live with two or more chronic conditions that worsen your quality of life and put your health at risk, chronic care …
Chronic Care - ThoroughCare
Chronic Care MANAGEMENT Care Coordination for Value-Based Care Success Software to effectively implement CCM, enhance care quality, and maximize Medicare incentive …
Improving quality outcomes for patients with chronic disease.
Our CMS approved case management company is built to deliver 24/7 service to patients with chronic care needs. CDS helps to create a comprehensive care plan that is based on a …
Microsoft Word - How to Set Up a Chronic Care Management …
By standard definition, chronic conditions cannot be cured by medicines or vaccinations, but care for chronic care patients can be managed to prevent exacerbations and ensure that they live …
Chronic Care Management (CCM): An Overview for Pharmicists
The key components of CCM include structured recording of patient health information, an electronic care plan addressing all health issues, access to care management services, …
The Future of Chronic Care Management (CCM)
The Assurance Chronic Care management solution combines advanced data-driven technology with personalized patient care to compliantly maximize the financial and clinical benefits of …
WHAT IS CHRONIC CARE MANAGEMENT (CCM)?
CCM engages patients in their own care and educates them on their chronic conditions. Separate from traditional primary care, it provides access to care outside of and in between doctors’ …
Chronic Care MANAGEMENT - ThoroughCare
Chronic Care MANAGEMENT Care Coordination for Value-Based Care Success Software to effectively implement CCM, enhance care quality, and maximize Medicare incentive …
Providing and Billing Medicare for Chronic Care …
Medicare began reimbursing physicians for chronic care management (CCM) services in January 2015 under CPT® 994901 in response to anecdotal evidence that care management services …
Chronic Care Management & Care Coordination
Chronic Care Management (CCM) is all about. The Chronic Care Management program entitles Medicare* patients with two or more chronic conditions, such as those listed on the previous …
Chronic Care Management Frequently Asked Questions
Aug 16, 2022 · This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS). What chronic care …
CMS Chronic & Principal Care Management Services: …
Nov 15, 2019 · Implementing the Centers for Medicare and Medicaid Services’ (CMS) chronic and principal care management (CCM/PCM) services provides an opportunity to put a framework …
Chronic Care Management Program
Carson Medical Group is now offering Chronic Care Management (CCM), a tool available to Medicare patients who are living with more than one chronic condition. This convenient and …
CHRONIC CARE MANAGEMENT
Dec 21, 2023 · Chronic Care Management-personalized and supportive services for patients with two or more non-complex chronic conditions to coordinate care and achieve positive health …
SECTION O – CHRONIC CARE MANAGEMENT PROGRAM
Louisiana Healthcare Connections (LHCC) will continue offering its current Chronic Care Management Programs (CCMPs), as well as implement additional planned CCMPs, to meet …
Care Management - Advisory
May 6, 2020 · Care management encompasses programs that help patients navigate clinical and non-clinical services and improve self-management. Services can include: personalized care …
CHRONIC CARE MANAGEMENT TOOLKIT
Chronic care management (CCM) is a critical component of primary care that contributes to better outcomes and higher satisfaction for patients. The Centers for Medicare & Medicaid Services …
MLN909188 Chronic Care Management Services - Centers …
CMS recognizes chronic care management (CCM) as a critical primary care service that contributes to better Medicare patient health and care. We pay for CCM services provided to …
Altysys _Chronic Care Management Model_Case study
Chronic disease management requires healthcare providers to closely monitor and support patients over extended periods. Clinics handling patients with conditions such as diabetes and …
Chronic Care Management
ChartSpan provides a fully-managed Chronic Care Management (CCM) program designed specifically for your practice. ChartSpan handles all moving parts of CCM for you. From …
WHAT IS CHRONIC CARE MANAGEMENT? - Centers for …
If you have Medicare or are dually eligible (Medicare and Medicaid) and live with two or more chronic conditions that worsen your quality of life and put your health at risk, chronic care …
Chronic Care - ThoroughCare
Chronic Care MANAGEMENT Care Coordination for Value-Based Care Success Software to effectively implement CCM, enhance care quality, and maximize Medicare incentive payments. …
Improving quality outcomes for patients with chronic disease.
Our CMS approved case management company is built to deliver 24/7 service to patients with chronic care needs. CDS helps to create a comprehensive care plan that is based on a …
Microsoft Word - How to Set Up a Chronic Care …
By standard definition, chronic conditions cannot be cured by medicines or vaccinations, but care for chronic care patients can be managed to prevent exacerbations and ensure that they live …
Chronic Care Management (CCM): An Overview for Pharmicists
The key components of CCM include structured recording of patient health information, an electronic care plan addressing all health issues, access to care management services, …
The Future of Chronic Care Management (CCM)
The Assurance Chronic Care management solution combines advanced data-driven technology with personalized patient care to compliantly maximize the financial and clinical benefits of new …
WHAT IS CHRONIC CARE MANAGEMENT (CCM)? - Centers …
CCM engages patients in their own care and educates them on their chronic conditions. Separate from traditional primary care, it provides access to care outside of and in between doctors’ …
Chronic Care MANAGEMENT - ThoroughCare
Chronic Care MANAGEMENT Care Coordination for Value-Based Care Success Software to effectively implement CCM, enhance care quality, and maximize Medicare incentive payments. …
Providing and Billing Medicare for Chronic Care …
Medicare began reimbursing physicians for chronic care management (CCM) services in January 2015 under CPT® 994901 in response to anecdotal evidence that care management services …
Chronic Care Management & Care Coordination
Chronic Care Management (CCM) is all about. The Chronic Care Management program entitles Medicare* patients with two or more chronic conditions, such as those listed on the previous …
Chronic Care Management Frequently Asked Questions
Aug 16, 2022 · This document answers frequently asked questions about billing chronic care management (CCM) services to the Physician Fee Schedule (PFS). What chronic care …
CMS Chronic & Principal Care Management Services: …
Nov 15, 2019 · Implementing the Centers for Medicare and Medicaid Services’ (CMS) chronic and principal care management (CCM/PCM) services provides an opportunity to put a framework …
Chronic Care Management Program
Carson Medical Group is now offering Chronic Care Management (CCM), a tool available to Medicare patients who are living with more than one chronic condition. This convenient and …
CHRONIC CARE MANAGEMENT
Dec 21, 2023 · Chronic Care Management-personalized and supportive services for patients with two or more non-complex chronic conditions to coordinate care and achieve positive health …
SECTION O – CHRONIC CARE MANAGEMENT PROGRAM
Louisiana Healthcare Connections (LHCC) will continue offering its current Chronic Care Management Programs (CCMPs), as well as implement additional planned CCMPs, to meet …
Care Management - Advisory
May 6, 2020 · Care management encompasses programs that help patients navigate clinical and non-clinical services and improve self-management. Services can include: personalized care …
