Erlanger s Care Transitions. Working Together. UT Resident Orientation June 26, 2015
|
|
|
- Giles French
- 8 years ago
- Views:
Transcription
1 Erlanger s Care Transitions Working Together UT Resident Orientation June 26, 2015
2 WHAT IS CARE TRANSITIONS?
3 What is Care Transitions? A program that has been formed to meet and exceed CMS changes from The Affordable Care Act.
4 Purpose of Care Transitions WHAT IS THE PURPOSE OF CARE TRANSITIONS? WHICH INSURANCES DOES IT INCLUDE?
5 Purpose: CMS Guidelines To decrease the overall readmission rates for the Medicare Fee for Service (A&B population). Medicare Railroad excluded Medicare C excluded
6 Purpose: CMS Guidelines Hospitals will be fined for Readmissions within 30 days for: Congestive Heart Failure Heart Attacks Pneumonia 2016 = COPD and Joint Replacements Discharges versus Readmissions (Explain)
7 Hospital Fines from CMS HOW DO THE FINES WORK?
8 How does this work? FINES 2011 = Jul 1, 2008 Jun 30, 2011 = 1% 2012 = Jul 1, 2009 Jun 30, 2012 = 2% 2013 = Jul 1, 2010 Jun 30, 2013 = 3% 2016 = Jul 1, 2013 Jun 30, 2016 = 3% Allowed so many readmissions per 3 year Once exceed then pay % of total cost
9 Erlanger s Care Transitions Program The Call Center Erlanger s Care Transitions Team
10 WHO QUALIFIES FOR THE CARE TRANSITIONS PROGRAM AT ERLANGER?
11 Qualifications Has to have Medicare Fee for Service (A&B) Has to have one of the six diagnoses: Congestive Heart Failure (CHF primary or secondary), Heart Attack, Pneumonia, Chronic Obstructive Pulmonary Disease (COPD primary or secondary), Total Hip Replacement, Total Knee Replacement Readmit within 30 days of discharge from hospital (no matter what the diagnosis)
12 Call Center CHF, Pneumonia, Heart attack, COPD, Total Hips/Total Knees 3 Calls 1 st = Within 48 hours after discharge 2 nd = Within 10 days after 1 st call 3 rd and final = Within 10 days after 2 nd call If patient goes to SNF or Rehab will call weekly until discharged home. Doesn t matter where patient lives!
13 Erlanger s Care Transitions Team Interviews/assesses each Medicare A&B readmission to see why they came back and what we can do to prevent another readmit Make recommendations to MDs and CMs Educates patient and family on disease and disease management and lack of understanding Encourages patient to claim disorder and become independent with care of disease. Encourages the use of Erlanger s entities (HHC, DME, Pharmacy = Continuity of Care). Calls patient weekly for 30 days (home/snf/rehab)
14 Does Care Transitions Work? Year All AMI CHF COPD PNU is through April of 2015
15 4 Main Reasons for Readmissions Did not get prescriptions filled or understand how to take prescriptions. Did not have a follow up PCP appointment or able to keep appointment. Did not understand discharge orders or given a copy of the discharge orders. Discharged to early
16 Solving Prescription s Problem Erlanger pharmacy = visits each care transition patient who is being discharged home Can determine if any scripts need pre-authorization (helps delay of taking med) Helps determine if can get it cheaper (antibiotic) Identifies med programs that can assist Educate patient on meds Assist in determining if any meds interact with each other. (Saving Lives or potential problems) MD can write an order for Erlanger Pharmacy referral Erlanger delivers medications to Hamilton County residents, SNFs, Rehabs
17 Solving PCP issue Case Management = assisting with PCP Clerk s to make follow-up appointments Less than 23% of patients have a PCP appointment before discharge See doctor in 2 4 weeks after discharge is not a PCP appointment! Care Transitions Clinic on Fridays (for Erlanger patients who do not have a PCP or can t get in for a couple of weeks. Must have insurance.) Number to make appointment is SNFs/Rehabs to make appointments before patient is discharged and if no PCP help them find one.
18 Solving Discharge Instruction Problem Call Center goes over discharge orders again on first call/visit. Erlanger patient s able to send them a copy of their orders if needed. Need to get copy of the discharge orders from facility (SNFs/Rehabs) sent to fax and make to ATTN: Paul Smith
19 Solving the Discharge to Early problem Care Transitions Manager follows up with every Medicare A&B readmit. Reviews chart fully and reviews information sent from SNFs and Rehabs as well as chart from last visit. Care Transitions Manager follows that patient for 30 days personally with calls and communications.
20 Home versus Home with HHC About 62% of patients go home without HHC and this has gotten better because about 6 months ago it was around 84% went home without HHC. What can qualify a patient for HHC? Nursing and PT can stand alone, all other areas need to have Nursing or PT ordered with it. Education of disease, Education of meds orders need to say Disease Management and Medication Management. If patient is having difficulty with specific things then be specific when ordering. (i.e. Dietary Management needs understanding of CHF diet and fluid restriction) Anyone with COPD or CHF should have a home med monitor. Order needs to say Home Med Tele Monitoring.
21 Keeping patients from being readmitted for 30 days What about patients that don t go home after discharge? Rehab SNFs How can care transitions assist you?
22 Rehabs/SNFs Communicate with Care Transitions staff (admission/discharge). Involve the Care Transitions Manager if family or patient is not progressing or if need an advocate. Encourage the use of Erlanger s HHC, DME, and Pharmacy Make sure patient has meds, copy of discharge orders, and follow-up appointments made before discharging from your facility Partnering with Erlanger to help decrease readmissions
23 Paul Smith s Contact Information Office number: Fax number: address: paul.smith@erlanger.org QUOTE: You can dream, create, design and build the most wonderful place in the world, but it requires people to make the dream a reality. -Walt Disney
24 QUESTIONS
Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System
Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System 1 Explain how patients experience transitions of care Identify variables that affect transitions due to lack of patient
Reducing Readmissions with Predictive Analytics
Reducing Readmissions with Predictive Analytics Conway Regional Health System uses analytics and the LACE Index from Medisolv s RAPID business intelligence software to identify patients poised for early
3/11/15. COPD Disease Management Tackling the Transition. Objectives. Describe the multidisciplinary approach to inpatient care for COPD patients
Faculty Disclosures COPD Disease Management Tackling the Transition Dr. Cappelluti has no actual or potential conflicts of interest associated with this presentation. Jane Reardon has no actual or potential
Henry Ford Health System Care Coordination and Readmissions Update
Henry Ford Health System Care Coordination and Readmissions Update September 2013 BACKGROUND Most hospital readmissions are viewed as avoidable, costly, and in some cases as a potential marker of poor
WHAT IS MEDICAL MANAGEMENT? WHAT IS THE PURPOSE OF MEDICAL MANAGEMENT?
WHAT IS MEDICAL MANAGEMENT? How health plans make decisions to approve payment for medical treatment is a poorly understood part of the healthcare system. One part of the process, known as medical management,
Hospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care
Hospital to Physician Office to Home: A Respiratory Led Program Across the Continuum of Care Charley P. Starnes, RRT, RCP Clinical Respiratory Specialist- COPD Education Important Milestones July 2011-
Medicare Savings and Reductions in Rehospitalizations Associated with Home Health Use
Medicare Savings and Reductions in Rehospitalizations Associated with Home Health Use June 23, 2011 Avalere Health LLC Avalere Health LLC The intersection of business strategy and public policy Table of
Home Health Care Today: Higher Acuity Level of Patients Highly skilled Professionals Costeffective Uses of Technology Innovative Care Techniques
Comprehensive EHR Infrastructure Across the Health Care System The goal of the Administration and the Department of Health and Human Services to achieve an infrastructure for interoperable electronic health
Plenary Session 1. Health Dimensions Group. 2010 Health Dimensions Group
Plenary Session 1 Kathleen M. Griffin, PhD Health Dimensions Group March 31, 2011 Hospital, Post Acute and Long-Term Care Collaboration in Health Care Reform: Critical Success Factors National Summit:
How Will Hospital Readmission Penalties Impact Skilled Nursing Facilities?
How Will Hospital Readmission Penalties Impact Skilled Nursing Facilities? Patrick V. Trotta, CPA Director of ElderCare Provider Services Glass Jacobson patrick.trotta@glassjacobson.com 410 356 1000 Presentation
Eddy VNA Care Transitions Program
Eddy VNA Care Transitions Program Patrick Archambeault RN, MS, CRNI Director of Clinical Specialties About Eddy VNA Large not for profit home care agency based in upstate New York CHHA, LTHHCP, Licensed
The Medicare Readmissions Reduction Program
The Medicare Readmissions Reduction Program Impact on Rural Hospitals Harvey Licht Varela Consulting Group August, 2013 CMS Readmissions Reduction Program: Authority Section 3025 of the Patient Protection
4/27/2015. LeadingAge Michigan 2015 Annual Conference Dearborn, MI Monday May 18th, 2015. Jon Golm, President
LeadingAge Michigan 2015 Annual Conference Dearborn, MI Monday May 18th, 2015 Jon Golm, President Aging Improving Enriched Post Discharge Services, LLC Outcomes Mike Logan, SVP/COO Wellspring Lutheran
Medical Necessity & Charting Guidelines
Medical Necessity & Charting Guidelines 1 In most cases we are told the rules up front - or will be told if we ask Like most games, the one who knows the rules the best WINS 4 2 Nationally Recognized Industry
It Takes Two to ACO A Unique Management Partnership
AMGA 2014 Annual Conference, April 4, 2014 It Takes Two to ACO A Unique Management Partnership Scott Hayworth MD, President & CEO Mount Kisco Medical Group Alan Bernstein MD, Senior Medical Director Mount
A Project to Reengineer Discharges Reduces 30-Day Hospital Readmission Rates. April 11, 2014
A Project to Reengineer Discharges Reduces 30-Day Hospital Readmission Rates April 11, 2014 About the QIO Program Leading rapid, large-scale change in health quality: Goals are bolder. The patient is at
Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights
Atrius Health Pioneer ACO: First Year Accomplishments, Results and Insights Emily Brower Executive Director Accountable Care Programs Emily_Brower@AtriusHealth.org November 2013 1 Contents Overview of
PREVENTING HEART FAILURE READMISSIONS
PREVENTING HEART FAILURE READMISSIONS Tanya Sprinkle, BSN, RN, CCM Patient and Family Services Coordinator tanya.sprinkle@iredellmemorial.org 704-878-4534 Michelle Roseman, NHA, MBA Chief Operating Officer/Catawba
Jon S. Howell, LNHA President & CEO Georgia Health Care Association November 18, 2013
Jon S. Howell, LNHA President & CEO Georgia Health Care Association November 18, 2013 GEORGIA HEALTH CARE ASSOCIATION Represents 336 skilled nursing facilities 13 SOURCE agencies 15 assisted living communities
Improving Care Transitions using PDSA Methodology
Improving Care Transitions using PDSA Methodology Catherine Payne, MD, FHM Care Transitions Physician Champion Medical Director of Clinical Informatics Erlanger Medical Center Chattanooga, Tennessee Objectives
Selling Care Transition Services to Hospitals
Selling Care Transition Services to Hospitals An Ankota White Paper By Ken Accardi, Founder/CEO 2015 Copyright 2015 Ankota LLC - All rights reserved. How to Sell Your Care Transition Services to Hospitals
Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION
Presented by Kathleen S. Wyka, AAS, CRT, THE AFFORDABLE CA ACT AND ITS IMPACT ON THE RESPIRATORY C PROFESSION At the end of this session, you will be able to: Identify ways RT skills can be utilized for
Care Transitions Training Videoconference December 17, 2009 Questions and Answers
1. Q: Will the transition log be sent to the counties and care systems electronically? A: It will be available on each health plan s Web page. If a website is not available, the plan will send the form
Using Root Cause Analysis to Determine Why Readmissions are High. Presentation Objectives. Background Information 11/30/2011
Using Root Cause Analysis to Determine Why Readmissions are High Nancy Seck RBN, BSN, MPH, CPHQ Director, Quality Management Glendale Memorial Hospital and Health Center Presentation Objectives Identify
MONTANA. Downloaded January 2011
MONTANA Downloaded January 2011 37.40.202 PREADMISSION SCREENING, GENERAL REQUIREMENTS (1) This rule provides the preadmission screening requirements of the Montana Medicaid program for applicants to nursing
How To Reduce Hospital Readmission
Reducing Hospital Readmissions & The Affordable Care Act The Game Has Changed Drastically Reducing MSPB Measures Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE Chuck Bongiovanni, MSW, MBA, NCRP, CSA, CFE
Innovations@Home. Home Health Initiatives Reduce Avoidable Readmissions by Leveraging Innovation
How Does CMS Measure the Rate of Acute Care Hospitalization (ACH)? Until January 2013, CMS measured Acute Care Hospitalization (ACH) through the Outcomes Assessment and Information Set (OASIS) reporting
Spalding Regional Hospital. Mobile Intergraded Health Care Shifting from Sick Care to Patient Centered Healthcare.
Spalding Regional Hospital Mobile Intergraded Health Care Shifting from Sick Care to Patient Centered Healthcare. Where is Spalding County in all of this? 2014 Unemployment Rate: 8.5% NR 6.8% Living Below
Learning Collaborative
Care Transitions Intervention Model to Reduce 30-Day Readmissions for Chronic Cardiac Conditions Learning Collaborative Dr. Norma Jean-Francois, DNP, APN-C Dr. Mary Anne Marra, DNP, MSN, RN, NEA-BC 1 OVERVIEW
5/10/13 HEALTH CARE REFORM LONGITUDINAL CARE COORDINATION HEALTH CARE REFORM WHY = VALUE WHY WHAT HOW WHEN WHO WHY WHAT HOW WHEN WHO
TRANSITION CARE TRANSITION CARE WHY WHAT HOW WHEN WHO HEALTH CARE REFORM HEALTH CARE REFORM WHY = VALUE WHY WHAT HOW WHEN WHO Cost/Quality equation Higher cost care has not/does not equate with higher
RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home
RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home Sergio Petrillo, PharmD Clinical Pharmacist Specialist, Rhode Island Hospital
Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases
Johns Hopkins HealthCare LLC: Care Management and Care Coordination for Chronic Diseases Epidemiology Over 145 million people ( nearly half the population) - suffer from asthma, depression and other chronic
Post discharge tariffs in the English NHS
Post discharge tariffs in the English NHS Martin Campbell Department of Health 4th June 2013 Contents Rationale and objectives Non payment for avoidable readmissions Development of post discharge tariffs
UTILIZATION MANAGEMENT PROGRAM Introduction Health Care Services
UTILIZATION MANAGEMENT PROGRAM Introduction Health Care Services Call us: 1-888-898-7969, Option 1, then Option 4 Fax us: 1-800-594-7404 Business hours: Monday Friday (excluding holidays), 8:30 a.m. to
How to Reduce Avoidable Readmissions Guidance for averting penalties and fostering healthier patients
How to Reduce Avoidable Readmissions Guidance for averting penalties and fostering healthier patients A white paper by Nexus Health Resources Dr. Virginia Feldman, Founder, President & CEO THE PROBLEM
COPD 30 Day Readmission Project SAINT THOMAS RUTHERFORD MURFREESBORO, TN SEPTEMBER 15, 2015 DAVID M. SELLERS, MD, MBA
COPD 30 Day Readmission Project SAINT THOMAS RUTHERFORD MURFREESBORO, TN SEPTEMBER 15, 2015 DAVID M. SELLERS, MD, MBA USA COPD Data 24 Million Americans under the age of 65 with COPD Almost 20% readmit
Population Health Management: Banner Health Network s Perspective. Neta Faynboym, Medical Director Banner Health Network
Population Health Management: Banner Health Network s Perspective Neta Faynboym, Medical Director Banner Health Network 29 Acute Care Hospitals BANNER AT A GLANCE Banner Health Network with 400K lives
RT AS PROJECT MANAGER:
RT AS PROJECT MANAGER: IMPROVING CARE TRANSITIONS DECREASES UNPLANNED READMISSIONS TAMMY JARNAGIN, BHS, RRT DIRECTOR CARDIOPULMONARY SERVICES, NEURODIAGNOSTICS, HOME MEDICAL EQUIPMENT Objectives Recognize
Care Coordination. The Embedded Care Manager. Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed
Care Coordination The Embedded Care Manager Presented by Thomas Decker, MD Mary Finnegan, BSN, M.Ed Goals of Care Management The goals of care Management are consistent with the Triple Aim: Improve population
Berkshire Medical Center Heart Failure Program
Berkshire Medical Center Heart Failure Program Reducing Readmissions A Multi Disciplinary Approach 1 Project Goals To improve the overall care of Berkshire County Heart Failure Patients Reduce 30 day readmission
2.b.vii Implementing the INTERACT Project (Inpatient Transfer Avoidance Program for SNF)
2.b.vii Implementing the INTERACT Project (Inpatient Transfer Avoidance Program for SNF) Project Objective: Skilled nursing facilities (SNFs) will implement the evidence based INTERACT program developed
PCMH and Care Management: Where do we start?
PCMH and Care Management: Where do we start? Patricia Bohs, RN, BSN Quality Assurance Manager Kelly McCloughan QA Data Manager Wayne Memorial Community Health Centers Honesdale, PA Wayne Memorial Community
Improving Transitions & Reducing Readmissions from Skilled Nursing Facilities. Amy E. Boutwell, MD, MPP Collaborative Healthcare Strategies
Improving Transitions & Reducing Readmissions from Skilled Nursing Facilities Amy E. Boutwell, MD, MPP Collaborative Healthcare Strategies Agenda Why this is so important What we know: a review of the
Discharge Planning. Home Care 1. Objectives. Where are they Going?
Discharge Planning Heidi White, MD Associate Professor of Medicine Yvonne Spurney, RN Associate Chief Nurse Cristina C. Hendrix, DNS, GNP-BC Associate Professor of Nursing Objectives Describe challenges
Southern California Patient Safety Collaborative
Southern California Patient Safety Collaborative Track II: Care Transitions March 6 th, 2012 Markus Mettler, NHA, PT : REDUCING SNF TO ACUTE RE-HOSPITALIZATIONS Markus Mettler, NHA, PT 20 years in Healthcare
1. Executive Summary Problem/Opportunity: Evidence: Baseline Data: Intervention: Results:
A Clinical Nurse Leader led multidisciplinary Heart Failure Program: Integrating best practice across the care continuum to reduce avoidable 30 day readmissions. 1. Executive Summary Problem/Opportunity:
Call-A-Nurse Location
Call-A-Nurse A 24-hour medical call center, specializing in registered nurse telephone triage, answering service, physician and service referral, and class registration. Call-A-Nurse Location Call-A-Nurse
Table 1 Performance Measures. Quality Monitoring P4P Yr1 Yr2 Yr3. Specification Source. # Category Performance Measure
Table 1 Performance Measures # Category Performance Measure 1 Behavioral Health Risk Assessment and Follow-up 1) Behavioral Screening/ Assessment within 60 days of enrollment New Enrollees who completed
Accountable Care Fundamentals for Medical Practice Executives
Accountable Care Fundamentals for Medical Practice Executives Nathan Anspach, FACMPE Senior Vice President and Chief Executive Officer John C. Lincoln Accountable Care Organization and John C. Lincoln
Clinic/Provider Name (Please Print or Type) North Dakota Medicaid ID Number
Contract to Provide Health Management Services Supplementary Agreement Between The Department of Human Services, Medical Services Division (North Dakota Medicaid) and Clinic/Provider Name (Please Print
May 9, 2013. FaithAnn Amond, RN Navigator Care Central Ellis Medicine
A Systems Approach to Diabetes Care Hospital to Home. Improving Care Transitions and Outcomes Helen Hayes Hospital West Haverstraw, NY James Desemone, MD Director of Medical Staff Quality Diabetes and
Moving Towards Bundled Payment
ISSUE BRIEF Moving Towards Bundled Payment Introduction The fee-for-service system of payment for health care services is widely thought to be one of the major culprits in driving up U.S. health care costs.
Advanced Solutions for Accountable Care Organizations (ACOs)
Advanced Solutions for Accountable Care Organizations (ACOs) Since our founding more than 21 years ago, Iatric Systems has been dedicated to supporting the quality and delivery of healthcare, while helping
Coordinating Transitions of Care: It Takes a Village
Coordinating Transitions of Care: It Takes a Village Ken Laube RN, BSN, MBA: Vice President Clinical Excellence Situation/Background Patients face significant challenges when moving from one health care
Kim Olmedo, LCSW, CCM CSW-G Social Work Manager, Silverback Care Management
Kim Olmedo, LCSW, CCM CSW-G Social Work Manager, Silverback Care Management According to AARP, about 8000 people turn 65 every day The Medicare Trustees have estimated that Medicare will run out of money
Readmissions as an Enterprise Priority. Presenters 4/17/2014
Readmissions as an Enterprise Priority April 24, 2014 Presenters Vincent A. Maniscalco, MPA, LNHA Administrator Middletown Park Rehabilitation and Health Care Center Vmaniscalco@parkmanorrehab.com Eileen
UCare provides case management for all UCare members not affiliated with one of the above listed care systems. 2011 UCare for Seniors
Case Requirements Updated 3/16/2011 According to the Case Society of America (CMSA), Case Model Act of 2009, Case management is a collaborative process of assessment, planning, facilitation, care coordination,
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Summit Health Plan of Florida Medicare Quality Management Program Overview Quality Improvement (QI) Overview At Coventry, we
ELECTRONIC MEDICAL RECORDS (EMR)
ELECTRONIC MEDICAL RECORDS (EMR) SAUDI BOARD FOR COMMUNITY MEDICINE FIRST PART - FIRST SEMESTER (FALL 2010) COURSE SBCM 002: MEDICAL INFORMATICS Osama Alswailem MD MA Medical Record function 1. It s a
Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals
Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals 12/18/2013 12/18/13 2013, American Heart Association 1 Thank you for Joining the Webinar Today. The Presentation will Begin
Nurse Transition Coach Model: Innovative, Evidence-based, and Cost Effective Solutions to Reduce Hospital Readmissions
Nurse Transition Coach Model: Innovative, Evidence-based, and Cost Effective Solutions to Reduce Hospital Readmissions Leslie Becker RN, BS Jennifer Smith RN, MSN, MBA Leslie Frain MSN, RN Jan Machanis
Guide to Choosing a Hospital
C E N T E R S F O R M E D I C A R E & M E D I C A I D S E R V I C E S Guide to Choosing a Hospital This official government booklet explains the following: Steps to find and compare hospitals Why hospital
Quality Scorecard overall heart attack care overall heart failure overall pneumonia care overall surgical infection rate patient safety survival
Quality Scorecard s are required to report quality statistics to the s for Medicare and Medicaid Services (CMS) and the Department of Health (DOH). This information is made available at www.hospitalcompare.hhs.gov
Preventing Readmissions
Emerging Topics in Healthcare Reform Preventing Readmissions Janssen Pharmaceuticals, Inc. Preventing Readmissions The Patient Protection and Affordable Care Act (ACA) contains several provisions intended
Concept Series Paper on Disease Management
Concept Series Paper on Disease Management Disease management is the concept of reducing health care costs and improving quality of life for individuals with chronic conditions by preventing or minimizing
MEDICARE RISK ADJUSTMENT A PROSPECTIVE APPROACH TO RISK ADJUSTMENT AND ACCURATE DOCUMENTATION AND CODING
MEDICARE RISK ADJUSTMENT A PROSPECTIVE APPROACH TO RISK ADJUSTMENT AND ACCURATE DOCUMENTATION AND CODING WHAT IS RISK ADJUSTMENT? Risk Adjustment ensures that accurate payments are made to Medicare Advantage
Special Needs Plan Model of Care 101
Special Needs Plan Model of Care 101 What is a Special Needs Plan? First of all it s a Medicare MA-PD, typically an HMO Consists of Medicare enrollees who meet special eligibility requirements In our case
Care Transitions: Success Stories and Lessons Learned
Care Transitions: Success Stories and Lessons Learned Kim McCoy, Stratis Health Kris Garman, Redwood Area Hospital Joleen Johnson, Redwood Area Hospital June 29, 2015 Objectives Learn strategies for implementation
How To Help A Nursing Home And Hospital Collaborate
Continuum of Care Bridging the Gap between the Hospital and Nursing Home Scott Wells, RN MSN Tiffany Noller, RN MSN Objectives Name key members involved in hospital/nursing home collaborative Identify
PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT. Norris Vivatrat, MD Associate Medical Director Monarch HealthCare
PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT Norris Vivatrat, MD Associate Medical Director Monarch HealthCare 2 Agenda Pioneer ACO basics, performance and challenges Monarch HealthCare Post-acute network
PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT
PIONEER ACO A REVIEW OF THE GRAND EXPERIMENT Norris Vivatrat, MD Associate Medical Director Monarch HealthCare 2 Agenda Pioneer ACO basics, performance and challenges Monarch HealthCare Post-acute network
Care Network of East Alabama, Inc.
Care Network of East Alabama, Inc. Established in 2011 as a not-for-profit organization to promote the medical home and to address the needs of Patient 1st patients in east Alabama Timeline December 2010
Success and Survival in Pulmonary Rehab
Success and Survival in Pulmonary Rehab 35 Years and Still Growing Valerie McLeod, RRT Manager, Pulmonary Rehabilitation McLaren Flint, MI Disclosure Information I have no disclosures. While some brands
Department of Human Services Health Care Reform Review Committee Representative George Keiser, Chairman March 19, 2014
Department of Human Services Health Care Reform Review Committee Representative George Keiser, Chairman March 19, 2014 Chairman Keiser, members of the Health Care Reform Review Committee, I am Julie Schwab,
Get With The Guidelines Best Practices: A look at reducing 30-day heart failure readmission rates
Get With The Guidelines Best Practices: A look at reducing 30-day heart failure readmission rates Thank you for joining the webinar! The presentation will begin shortly. *Please make sure your computer
Patient to Person. Transitions of Care. Colby Bearch, MA-SF, MA-M, BA, RN, CDONA Sharyn King, RN, BSN, CCM
Patient to Person Transitions of Care Colby Bearch, MA-SF, MA-M, BA, RN, CDONA Sharyn King, RN, BSN, CCM Transitions of Care Transitioning from school to adult services (vocational, medical day, etc.)
INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS. Karen Unholz, RN, BSN
INTRO TO THE MICHIGAN PIONEER ACO 101: THE BASICS Karen Unholz, RN, BSN Origins of the Accountable Care Organization ACOs originated from the Patient Protection and Affordable Care Act (Healthcare Reform)
Patients Receive Recommended Care for Community-Acquired Pneumonia
Patients Receive Recommended Care for Community-Acquired Pneumonia For New Jersey to be a state in which all people live long, healthy lives. DSRIP LEARNING COLLABORATIVE PRESENTATION The Care you Trust!
Care Transitions: How Can You Help?
Better Health: It s Your Health, Take Charge Transitions of Care: Coordination and Management Care Transitions: How Can You Help? presented by: Anne Elwell, RN, MPH Principal and Vice President, Qualidigm
Service delivery interventions
Service delivery interventions S A S H A S H E P P E R D D E P A R T M E N T O F P U B L I C H E A L T H, U N I V E R S I T Y O F O X F O R D CO- C O O R D I N A T I N G E D I T O R C O C H R A N E E P
Health Insurance A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. HL-14-001 Rev. 08/2015
A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE The of Health Insurance wahealthplanfinder.org 1-855-WAFINDER 1-855-923-4633 HL-14-001 Rev. 08/2015 THE ABC S OF HEALTH INSURANCE: WHY IS HEALTH
Goals and Objectives
Care Transitions from the Skilled Nursing Facility Perspective: What Hospitals Need to Know Lessons Learned from working in a Skilled Nursing Facility Presented by: Pat Sutton, LSCW, ACM Goals and Objectives
Understanding Care Transitions as a Patient Safety Issue
Article reprinted from Patient Safety & Quality Healthcare, May/June 2011 Understanding Care Transitions as a Patient Safety Issue By Sara Butterfield RN, BSN, CPHQ, CCM; Christine Stegel, RN, MS, CPHQ;
The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM. Sue Thompson Chief Executive Officer
The Trinity Pioneer Story ACO SETTLERS THE PIONEER JOURNEY TO THE TRIPLE AIM Sue Thompson Chief Executive Officer 2 UnityPoint Health: Organizational Profile 3 4 UnityPoint Health Fort Dodge: Organizational
Nursing Home to Community Program: A Discharge Planning Manual
Nursing Home to Community Program: A Discharge Planning Manual March 2006 Portions of this Manual may be cited on condition that proper credit is given to: Broome County Community Alternative Systems Agency
POLICY BRIEF. Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time? October 2015. rhrc.umn.edu
POLICY BRIEF October 2015 Which Rural and Urban Hospitals Have Received Readmission Penalties Over Time? Peiyin Hung, MSPH Michelle Casey, MS Ira Moscovice, PhD Key Findings Over the first three years
A partnership that offers an exclusive insurance product! The Chambers of Commerce in Hamilton County and ADVANTAGE Health Solutions, Inc.
The Chambers of Commerce in Hamilton County and ADVANTAGE Health Solutions, Inc. SM A partnership that offers an exclusive insurance product! CHAMBER OF COMMERCE The Chambers of Commerce in Hamilton County
10/24/2014. 9 th Annual Nursing Research Conference Presented By: Heather Powell & Jeanmarie Okoniewski
9 th Annual Nursing Research Conference Presented By: Heather Powell & Jeanmarie Okoniewski Heather J. Powell, MSN, RN, RN-BC Kimberly D. Williams, MPH Jeanmarie Okoniewski, MSN, RN, RN-BC Melinda Acevedo,
CHANGING YOUR CASE MANAGEMENT MODEL OF CARE. Jan Lear, RN, CMC Director of Case Management MedStar Franklin Square Medical Center
CHANGING YOUR CASE MANAGEMENT MODEL OF CARE Jan Lear, RN, CMC Director of Case Management MedStar Franklin Square Medical Center 1 Program Objectives To be able to describe the compliance and regulatory
Accountable Care Organizations
Accountable Care Organizations Myth, Reality, Facts Why =System Failure Low Quality - IOM report High Cost Quality Cost disconnect Low Value Problems Disconnect between Quality and Cost Care is fragmented
NAVIGATING THE MEDICARE MAZE OF REHABILITATIVE SERVICES
NAVIGATING THE MEDICARE MAZE OF REHABILITATIVE SERVICES NAVIGATING THE COMPLEXITY OF INSURANCE COVERAGE. Fox Rehabilitation is a private practice of physical, occupational, and speech therapists who specialize
The Cost-Effectiveness of Homecare
The Cost-Effectiveness of Homecare Homecare Reduces Costs by 37 Percent for Heart Failure Patients The May 2004 Journal of the American Geriatrics Society reports a study conducted at six Philadelphia
Avoiding Rehospitalizations in LTC Chris Osterberg, RN BSN Pathway Health Services
Avoiding Rehospitalizations in LTC Chris Osterberg, RN BSN Pathway Health Services Objectives Understand the new consequences to hospitals for discharged clients being re-admitted within selected time
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including
The Centers for Medicare & Medicaid Services (CMS) strives to make information available to all. Nevertheless, portions of our files including charts, tables, and graphics may be difficult to read using
A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. Health Insurance
A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE The of Health Insurance THE ABC S OF HEALTH INSURANCE: WHY IS HEALTH INSURANCE IMPORTANT? Even if you are in GOOD HEALTH, you will need to
DEPARTMENT OF HEALTH AND HUMAN SERVICES. Medicare Program; Request for Applications for the Medicare Care Choices Model
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [CMS-5512-N] Medicare Program; Request for Applications for the Medicare Care Choices Model AGENCY: Centers for Medicare
Utilization Management Program
Utilization Management Program The Utilization Management (UM) Program facilitates quality, cost-effective and medically appropriate services across a continuum of care that integrates a range of services
Billing and Coding Update in the Nursing Home 2015
Billing and Coding Update in the Nursing Home 2015 Charles Crecelius MD PhD FACP CMD Agenda Review of nursing home basic coding requirements Use of NPP New Transition of Care code Ancillary CPT codes,
BUNDLING ARE INPATIENT REHABILITATION FACILITIES PREPARED FOR THIS PAYMENT REFORM?
BUNDLING ARE INPATIENT REHABILITATION FACILITIES PREPARED FOR THIS PAYMENT REFORM? Uniform Data System for Medical Rehabilitation Annual Conference August 10, 2012 Presented by: Donna Cameron Rich Bajner