In the recently published 2012 IPPS Rules, CMS introduced the first efficiency measure--cost per Medicare beneficiary.  The rules also discussed a future efficiency measure--length of stay (LOS). Neither of these two measures is new for the case managers' focus, but this is the first time this data will be published and on which reimbursement will be based.  

The last 90-minute webinar in “The Case Manager’s Role in Reimbursement and Healthcare Reform Series,” by case management experts Dr. Toni Cesta and Bev Cunningham, RN, MS will discuss best practice case management strategies for decreasing costs and LOS.  Rather than looking only at strategies of the past, this presentation will incorporate strategic methods for impacting these results.  Also to be discussed will be the alignment of efficiency and quality, strategies for each hospital discipline will be reviewed, as will methods for hardwiring process improvement steps for positive impact in these efficiency measures.  It is crucial that case managers not only have strategies within the department, but integrated with other disciplines throughout the hospital.  Our results are now on the line, so join us to discuss how you can improve your publicly reported results.

Learning Objectives:

• Develop integrated strategies to assure optimal publicly reported efficiency measures.
• Discuss the role of the case manager in improving the cost per case and LOS efficiency measures.
• Identify methods for understanding your hospital's efficiency measure results.

Target Audience:

• Case Management Directors and Managers 
• Discharge Planning Directors and Managers 
• Patient Care Services Professionals 
• Quality Assurance Directors and Managers 
• Social Workers and Social Service Directors 
• Utilization Management Directors and Managers 

Level: All levels

Meet Your Experts:

Toni G. Cesta, Ph.D., RN, FAAN is Senior Vice President for Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York. Additionally, Dr. Cesta serves as Health Care Consultant and partner in Case Management Concepts, LLC, a consulting company assisting institutions in designing, implementing and evaluating case management models, new documentation systems, and other strategies for improving care and reducing cost. Dr. Cesta has presented and published extensively on case management topics. She has presented at national and international conferences and workshops, and is the author of "Nursing Case Management: From Essentials to Advanced Practice Applications" and the best selling book - "The Case Manager's Survival Guide: Winning Strategies for Clinical Practice". In 2009 Dr Cesta co-authored a new book "Case Management Core Skills" with Beverly Cunningham. Dr. Cesta has also been active in the research and development of case management for 20 years. She is Consulting Editor of "Hospital Case Management Journal" and serves as editorial advisory board member of several case management journals and publications including "Strategies for Healthcare Excellence" and "The Journal of Care Management."

Bev Cunningham, RN, MS is a Vice President, Clinical Performance Improvement at Medical City Dallas Hospital.  Her responsibilities include Case Management, Health Information Management, Documentation Integrity, Quality Management, Patient Access and Transplant Financial Services. Bev is a well-known speaker in the Case Management field and she has presented internationally. Her area of expertise includes denials management, patient flow and the role of the Case Manager and Social Worker in the Case Management process.  She has served as a Commissioner on the Commission for Case Management Certification and is a fellow with the Advisory Board.

Bev is also a partner and consultant in Case Management Concepts, a company that provides international support to hospitals regarding effective Case Management model development and evaluation. Bev's publications include a chapter CMSA's Core Cirriculum for Case Management Certification and most recently, co-author of the book, Core Skills for Hospital Case Management.  She is on the advisory board for American Health Consultant's publication, Hospital Case Management.

Accreditation Statement:

AHC Media is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

Credit Designation:

This activity has been approved for 1.5 nursing contact hours using a 60-minute contact hour.

Provider approved by the California Board of Registered Nursing, Provider # 14749, for 1.5 Contact Hours.

This program has been approved by the Commission for Case Manager Certification for 1.5 clock hours.

Sponsor:

The sponsor of this educational activity is AHC Media.

Recorded: Tuesday, December 6, 2011