Nurses: Architects of an Integrated Healthcare Delivery System. Billie Lynn Allard, MS, RN Administrative Director of Outpatient Services
|
|
- Giles Stanley
- 8 years ago
- Views:
Transcription
1 Nurses: Architects of an Integrated Healthcare Delivery System Billie Lynn Allard, MS, RN Administrative Director of Outpatient Services Presentation ID: 338 1
2 Disclosure Today s presenters do not have any relevant financial interests presenting a conflict of interest to disclose. Participants must attend the entire session(s) in order to earn contact hour credit. Continuing Nursing Education credit can be earned by completing the online session evaluation. The American Organization of Nurse Executives is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center s Commission on Accreditation. AONE is authorized to award one hour of pre-approved ACHE Qualified Education credit (non-ache) for this program toward advancement, or recertification in the American College of Healthcare Executives. 2
3 Objectives Partner with key customers and stake holders to design a local, integrated healthcare delivery system Respond to care and assess gaps in your community by redeploying existing resources Formulate a care delivery implementation plan, gaining endorsement and support for necessary resources 3
4 Southwestern Vermont Healthcare Community Hospital Setting Cancer Center Medical Offices Long Term Care Hospital United Counseling 4
5 SVHC is a Health System part of One Care ACO OneCare Vermont 2 Academic Medical Centers 13 Community Hospitals 1 Behavioral Health Facility 2 Federally Qualified Health Centers 5 Rural Health Clinics 58 Private Practices 280 Primary Care Physicians 42,000 Medicare beneficiaries 5
6 Clinical Nurse Specialists in the Future Visualization Exercise at Retreat 6
7 Naylor Model Transitions of Care of 7
8 Working with the CFO Fee for Service Global Budget 8
9 Patient is introduced to the TCN during a scheduled visit. Patient Transitions to Subacute Care TCN does warm hand off and participates in care plan Primary Care Provider (PCP) Patient Transitions Home Patient Transitions to Hospital TCN shares pertinent data with care team. TCN visits patient within hours of notification to review discharge plan, assist with medication reconciliation, plan referral appointments, and provides plan for symptom management, what they can expect and what actions to take 9
10 One TCN One Practice (Village Primary Care) 10
11 Transitional Care Program Social work Pharmacist Diabetes educator Respiratory Therapist Lifeline Nursing Home Medicaid case manager Physical Therapy Dietician Assisted Living Rehab Center Transitional Care Patient and Family Team Home Meals on Wheels Hospice Hospital VNA Hotel Hostel (homeless) Soup Kitchen Council on Aging Emergency Department PCP office Adult Daycare United Counseling Services Physicians (specialists) SASH Case Management (Hospitals) 11
12 Fresh eyes can see clearly ED Care Plan Development Medication Reconciliation CHF/COPD Care Pharmacy Consultation and Education Transitions of Care (Gap Analysis) Community Care Team Integrated Diabetes Education Social Work Access Interact 12
13 Redeployment of Hospital Resources 13
14 Challenges No thank you! from Medical Home Overlap of services with home care nurses Why masters prepared nurse? Clarity of role explanation and communication Early identification of patients by health team 14
15 Where we are now Regional Clinical Performance Committee Contract with CMS Jan 2017 (Maryland plan) 4 TCNs partnered with all PCP offices 15
16 Reducing the actual cost of care 16
17 Reducing the actual cost of care 17
18 Gaps Solutions Standardization of care Clinical Pharmacist Pulmonary Rehab Interact Implementation Community Care Team 18
19 Daily Huddle 19
20 Relationships Building Northshire Medical Center Medical Home Case Manager Nursing Home Admission Nurse 20
21 Interact Implementation 21
22 Community Care Team (Program modeled after Middlesex Hospital, Connecticut) 22
23 Plugging the gaps Outpatient Dietitian Diabetes Education Respiratory Therapy Rehabilitation 23
24 Clinical Pharmacist 24
25 Integrated Social Work 25
26 Visiting Nurse relationship 26
27 Future Nursing Curriculum 27
28 Grant Funding Care Fusion VHCIP (State of Vermont) Hillman Foundation finalist 28
29 Patient Satisfaction Tool 1. My Transitional Care nurse helped me feel more confident that I can manage my medications. 2. My Transitional Care nurse helped me learn about my illness and how to manage it better. 3. My Transitional Care nurse helped me learn when to call the doctor, go to the emergency room or call 911. Always Usually Seldom Never Does not apply to me The nurse worked with me to enforce the importance of taking my medication and how to stay healthy. I was also educated on signs to watch for before this situation could go bad. I just look at my refrigerator and then I know when I need to call the Doctor. Since I ve been in the Transitions of Care program, I weigh myself everyday. 29
30 Quality of Life 30
31 CPT Codes for Transitions Center for Medicare and Medicaid Services and major insurance carriers The health care professional accepts care of the beneficiary post discharge from the facility setting without a gap. 31
32 Sharing our story. Geriatrics 2014 Evolving Role of the Transitional Care Nurse in a Small Rural Community Jennifer Fels, MS, RN, Billie Lynn Allard, MS, RN, Karen Coppin, MSN, RN, CEN, Karen Hewson, MSN, RN, and Barbara Richardson, MSN, RN-BC, CCRN Home Health Care Journal 32
33 Shift in utilization (lower cost setting) for residents of Bennington County. 33
34 Shift in utilization to primary care (lower cost setting) for residents of Bennington County. 34
35 Transitional Care Nursing -- Bennington, Vermont Comparison of ED Visits and Hospital Admissions Before/After TCN (n=101 patients on TCN program 120 days) Encounters Type 0 Before TCN After TCN ED Visits Before TCN After TCN Hospital Admissions Data Source: SVMC ED Visits September 2013 through September
36 Most recent data placeholder 36
37 Most recent data placeholder 37
38 Most recent data placeholder 38
39 Future Legislative Advocacy 39
40 NURSES Nurses created the synergy, capitalized on relationships, broke through resistance, waited patiently, worked tirelessly, produced results, shared data, leveraged opportunities and empowered patients. Patient Centered Integrated Care Delivery 40
41 The Beginning Helen Fairchild Florence Nightingale Mary Seacole Mary Mahoney Clara Barton 41
42 Nursing Leadership 42
43 TCN Nurse 43
44 Clinical Nurse Specialist 44
45 Maternity Nurses 45
46 CEO, CNO, Director Of Inpatient Services and MPD 46
47 Pulmonary Rehab 47
48 Medical Surgical Nurse 48
49 Long Term Care Leadership 49
50 Medical Surgical Nurses 50
51 Renal Dialysis Nurse 51
52 2013 Magnet Conference 52
53 Cardiac Nurse 53
54 Emergency Department Team 54
55 Special Procedure Nurse 55
56 TCN s and MPD 56
57 Maternity Nurses 57
58 Endoscopy Team 58
59 Operating Room Nurses 59
60 Nursing Professional Day 60
61 Visiting Nursing Association 61
62 Labor and Delivery Nurse 62
63 Peri-operative Nurse 63
64 Nurse Interns and Educator 64
65 Pediatric Nurse 65
66 Cardiac Rehab Team 66
67 Intensive Care Nurse 67
68 Architects of Healthcare Delivery LET S DO IT!
69 Thank You Billie Lynn Allard, MS, RN Southwestern Vermont Health Care 100 Hospital Drive, Bennington, Vermont (phone) 69
Coverage Basics. Your Guide to Understanding Medicare and Medicaid
Coverage Basics Your Guide to Understanding Medicare and Medicaid Understanding your Medicare or Medicaid coverage can be one of the most challenging and sometimes confusing aspects of planning your stay
More informationHelen M. Simpson Rehabilitation Hospital Leveraging IT to Coordinate Care Transitions
Helen M. Simpson Rehabilitation Hospital Leveraging IT to Coordinate Care Transitions All speakers have completed commercial bias disclosure forms and do not have any conflicts of interest Disclosures
More informationWhat is an Accountable Care Organization & Why is it Important to Your Home Infusion Company?
What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures
More informationWhat is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Disclosures. Overview 3/10/2015
What is an Accountable Care Organization & Why is it Important to Your Home Infusion Company? Lisa Harvey McPherson RN, MBA, MPPM EMHS Vice President Continuum of Care & Chief Advocacy Officer Disclosures
More informationBilling Repetitive Services March 7, 2013 Karen Kroupa, Outreach Analyst
Billing Repetitive Services March 7, 2013 Karen Kroupa, Outreach Analyst Agenda Defining Repetitive Services Billing Repetitive Services Leave of Absence Non-Repetitive-Services Billing Recurring Services
More informationZ Take this folder with you to your
my health care notebook Why? Being an active part of your health care team helps you feel better and helps you get even better care. Starting on Day 1, you can keep track of important information and questions.
More informationMedicare Billing for DSME and MNT Services
Medicare Billing for DSME and MNT Services Jo Ellen Condon, RD, CDE Barbara Eichorst, MS, RD, CDE Director of Education Recognition American Diabetes Association Vice President of Clinical Healthy Interactions
More informationNavigating Change in Health Care Reform: Who s Role the CNO or CMO? Presentation ID: W4 Mary Jo Snyder, RN, MS, MBA. Presentation ID: W4
Navigating Change in Health Care Reform: Who s Role the CNO or CMO? Presentation ID: W4 Mary Jo Snyder, RN, MS, MBA Presentation ID: W4 Today s presenters do not have any relevant financial interests presenting
More informationSouthwestern Vermont Medical Center Operating Budget Fiscal Year 2016
Southwestern Vermont Medical Center Operating Budget Fiscal Year 2016 Southwestern Vermont Medical Center s (hereafter SVMC or Medical Center ) Operating Budget for Fiscal Year (hereafter FY ) 2016 has
More informationThis information is provided by SRC for Medicare Information. (The costs that are used in these examples are from 2006.)
Medicare Information Source This information is provided by SRC for Medicare Information. (The costs that are used in these examples are from 2006.) The Senior Resource Center for Medicare Information
More informationPatient Information Guide. Getting you Back to Better. 859.426.2400 www.vrhgateway.com
Patient Information Guide Getting you Back to Better 859.426.2400 www.vrhgateway.com The Gateway Difference Gateway Rehabilitation Hospital provides expert care to help patients get back to better after
More informationHeart Failure & Cardiac Rehabilitation
Heart Failure & Cardiac Rehabilitation Karen Lui, RN, MS, MAACVPR SCACVPR Greenville May 3, 2014 1 I have no disclosures. 2 Outline New Professional Certification New AACVPR CR Guidelines New Heart Failure
More informationCHAPTER 600 PROVIDER QUALIFICATIONS AND PROVIDER REQUIREMENTS 600 CHAPTER OVERVIEW... 600-1 610 AHCCCS PROVIDER QUALIFICATIONS...
600 CHAPTER OVERVIEW... 600-1 REFERENCES... 600-2 610 AHCCCS PROVIDER QUALIFICATIONS... 610-1 EXHIBIT 610-1 AHCCCS PROVIDER TYPES 620 AHCCCS FFS MINIMUM NETWORK REQUIREMENTS... 620-1 630 MEDICAL RECORD
More informationClinical Nurse Specialist Practice Across the Continuum
Clinical Nurse Specialist Practice Across the Continuum Angela Rowe, MSN, APRN, PCNS-BC Pediatric Clinical Nurse Specialist Arkansas Children s Hospital Presentation ID: CD3 Disclosure Today s presenters
More informationTHE NEXT FRONTIER OF UNDERSTANDING NURSING TIME IN THE EMR
THE NEXT FRONTIER OF UNDERSTANDING NURSING TIME IN THE EMR Presentation ID: 484 Nikki Polis PhD, RN SVP and CNE Methodist LeBonheur Healthcare Interim CNO LeBonheur Children's Hospital Memphis, TN Darinda
More informationDisclosure. Today s presenters do not have any relevant financial interests presenting a conflict of interest to disclose.
Disclosure Today s presenters do not have any relevant financial interests presenting a conflict of interest to disclose. Participants must attend the entire session(s) in order to earn contact hour credit.
More information(A) Information needed to identify and classify the hospital, include the following: (b) The hospital number assigned by the department;
3701-59-05 Hospital registration and reporting requirements. Every hospital, public or private, shall, by the first of March of each year, register with and report to the department of health the following
More informationINTRO 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)
More informationcaresy caresync Chronic Care Management
caresy Chronic Care Management THE PROBLEM Chronic diseases and conditions, including heart disease, diabetes, COPD and obesity, are among the most common, expensive, and preventable health problems in
More informationIdaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs
Idaho Health Home State Plan Amendment Matrix: Summary Overview This matrix outlines key program design features from health home State Plan Amendments (SPAs) approved by the Centers for Medicare & Medicaid
More informationBridging Community Health Nursing & Primary Care to Communities Devastated by Hurricane Sandy
Bridging Community Health Nursing & Primary Care to Communities Devastated by Hurricane Sandy Mary Ann Christopher, MSN, RN, FAAN Yvonne Eaddy, MPH, BSN, RN Eloise Goldberg, MSN, BSN, RN Jill Goldstein,
More informationCare 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
More informationKaiser Permanente Guide to Medicare Basics
Kaiser Permanente Guide to Medicare Basics The National Medicare program, which was created in 1965, has given people peace of mind and the security of knowing they ll have access to health coverage. Medicare
More informationFrequently Asked Questions Regarding At Home and Inpatient Hospice Care
Frequently Asked Questions Regarding At Home and Inpatient Hospice Care Contents Page: Topic Overview Assistance in Consideration Process Locations in Which VNA Provides Hospice Care Determination of Type
More informationJoan 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
More informationHow To Improve A Nursing Practice
Making Lemonade from a Lemon of an NDNQI RN Survey: Nurse Managers and Clinical Nurses Collaborating to Improve the Practice Environment Session ID#: L8 Kathie Krause MSN, RN, NNP-BC, NEA-BC Vice President
More informationDisease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification
Disease Management UnitedHealthcare Disease Management (DM) programs are part of our innovative Care Management Program. Our Disease Management (DM) program is guided by the principles of the UnitedHealthcare
More informationUTILIZATION 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
More informationInitial Preventive Physical Examination
Initial Preventive Physical Examination Overview The Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003 expanded Medicare's coverage of preventive services. Central to the Centers
More informationLearning 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
More informationNational Stroke Association s Guide to Choosing Stroke Rehabilitation Services
National Stroke Association s Guide to Choosing Stroke Rehabilitation Services Rehabilitation, often referred to as rehab, is an important part of stroke recovery. Through rehab, you: Re-learn basic skills
More information3/11/15. 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
More informationNOTICE OF PRIVACY PRACTICES. The University of North Carolina at Chapel Hill. UNC-CH School of Nursing Faculty Practice Carolina Nursing Associates
NOTICE OF PRIVACY PRACTICES The University of North Carolina at Chapel Hill UNC-CH School of Nursing Faculty Practice Carolina Nursing Associates THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU
More informationUnitedHealthcare Choice Plus. United HealthCare Insurance Company. Certificate of Coverage
UnitedHealthcare Choice Plus United HealthCare Insurance Company Certificate of Coverage For Westminster College Enrolling Group Number: 715916 Effective Date: January 1, 2009 Offered and Underwritten
More informationJohns 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
More informationNurse 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
More informationASN Dialysis Advisory Group ASN DIALYSIS CURRICULUM
ASN Dialysis Advisory Group ASN DIALYSIS CURRICULUM 0 ASN Dialysis Curriculum Staffing in Dialysis Units Gina Randolph, RN, MSN, MBA Affiliations: DaVita, Inc. (employee) 1 What Determines Staffing Needs?
More information4/27/2015. 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
More informationAnnual Notice of Changes for 2015
Cigna HealthSpring Premier (HMO POS) offered by Cigna HealthSpring Annual Notice of Changes for 2015 You are currently enrolled as a member of Cigna HealthSpring Premier (HMO POS). Next year, there will
More informationMedicaid Support for Community Prevention
Medicaid Support for Community Prevention ASTHO Million Hearts Peer Call April 4, 2014 Anne De Biasi Director of Policy Development About TFAH: Who We Are Trust for America s Health (TFAH) is a non-profit,
More informationUCare 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,
More informationAMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Verificatoin Criterea EFFECTIVE JANUARY 1, 2015. Criterion. Level (1 or 2) Number
Criterion AMERICAN BURN ASSOCIATION BURN CENTER VERIFICATION REVIEW PROGRAM Criterion Level (1 or 2) Number Criterion BURN CENTER ADMINISTRATION 1. The burn center hospital is currently accredited by The
More informationESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION)
ESSENTIA HEALTH AS AN ACO (ACCOUNTABLE CARE ORGANIZATION) Hello and welcome. Thank you for taking part in this presentation entitled "Essentia Health as an ACO or Accountable Care Organization -- What
More informationOBSERVATION CARE EVALUATION AND MANAGEMENT CODES
REIMBURSEMENT POLICY OBSERVATION CARE EVALUATION AND MANAGEMENT CODES Policy Number: ADMINISTRATIVE 232.8 T0 Effective Date: April, 205 Table of Contents APPLICABLE LINES OF BUSINESS/PRODUCTS... APPLICATION...
More informationMedicare Advantage Plans: An Overview
Medicare Advantage Plans: An Overview June 2014 Prepared by: Penny Finch, Benefits Consultant Copyright 2014 by The Segal Group, Inc. All rights reserved. 5432273.1 CONTENTS Medicare 101 Understanding
More informationMedicare. Medicare Overview. Medicare Part D Prescription Plans. Medicare
58 requires enrollment as soon as a retiree, spouse or dependent of a retiree is eligible for. Parts A & B MUST be elected. Overview There are three parts to : Hospital Insurance (also called Part A. Your
More informationV. Utilization Management (UM) Program
V. Utilization Management (UM) Program Overview Better Health Network s Utilization Management (UM) Program is designed to provide quality, cost-effective and medically necessary services while meeting
More informationHow To Help Your Health System With The National Rural Accountable Care Consortium
and FAQ s 2016 Medicare Shared Savings Program Year Who is the National Rural Accountable Care Consortium? The National Rural Accountable Care Consortium was formed in 2013 to pool knowledge, patients,
More informationBuilding an Accountable Care Organization. Jean Malouin, MD MPH University of Michigan Health System September 21, 2012
Building an Accountable Care Organization Jean Malouin, MD MPH University of Michigan Health System September 21, 2012 Agenda UMHS overview PGP demo ACO precursor Current efforts underway Role of primary
More informationUW MEDICINE PATIENT EDUCATION. Your Care Team. Helpful information
UW MEDICINE PATIENT EDUCATION Your Care Team Helpful information In this section: You: The Patient Medical Staff Nursing Staff Allied Health Professionals Support Staff Peer Mentors for People with Spinal
More informationALBERTA S HEALTH SYSTEM PERFORMANCE MEASURES
ALBERTA S HEALTH SYSTEM PERFORMANCE MEASURES 1.0 Quality of Health Services: Access to Surgery Priorities for Action Acute Care Access to Surgery Reduce the wait time for surgical procedures. 1.1 Wait
More informationInstructions for Completing the CMS 1500 Claim Form
Instructions for Completing the CMS 1500 Claim Form The Center of Medicaid and Medicare Services (CMS) form 1500 must be used to bill SFHP for medical services. The form is used by Physicians and Allied
More informationAONE Nurse Manager Fellowship Program 2013 30 For the Price of One. Presentation ID: L1
AONE Nurse Manager Fellowship Program 2013 30 For the Price of One Presentation ID: L1 Disclosures Today s presenters do not have any relevant financial interests presenting a conflict of interest to disclose.
More informationRIH 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
More informationThank you... 1 www.bcbsga.com WPADVBR005M(11)-GA 20550WPSENMUB_004_G 9/11
Thank you... for your interest in our Medicare Supplement plans. We designed them to help you stay healthy and keep your medical costs down. It s why they are so popular. You get an added layer of security,
More informationHealthy Michigan MEMBER HANDBOOK
Healthy Michigan MEMBER HANDBOOK 2014 The new name for Healthy 1 TABLE OF CONTENTS WELCOME TO HARBOR HEALTH PLAN.... 2 Who Is Harbor Health Plan?...3 How Do I Reach Member Services?...3 Is There A Website?....
More informationAnn Hablitzel, RN, BSN, MBA Hospice Care of California
Ann Hablitzel, RN, BSN, MBA Hospice Care of California Objectives Describe the creations of new community based palliative care programs Identify criteria for admission Discuss philosophy and goals Analyze
More informationFor Family Caregivers: Leaving the Hospital and Going Where?
Family Caregiver Guide For Family Caregivers: Leaving the Hospital and Going Where? Planning for care after a discharge is often stressful. A thoughtful discussion with a knowledgeable professional can
More informationProgram Description and FAQ s 2016 Medicare Shared Savings Program Year
and FAQ s 2016 Medicare Shared Savings Program Year Who is the National Rural ACO? The National Rural ACO was formed in 2013 to pool knowledge, patients, and resources so that independent community health
More information1900 K St. NW Washington, DC 20006 c/o McKenna Long
1900 K St. NW Washington, DC 20006 c/o McKenna Long Centers for Medicare & Medicaid Services U. S. Department of Health and Human Services Attention CMS 1345 P P.O. Box 8013, Baltimore, MD 21244 8013 Re:
More informationFirst Choice VIP Care PLUS. Healthy Connections Prime Medicare Medicaid Benefits
First Choice VIP Care PLUS Healthy Connections Prime Medicare Medicaid Benefits Benefits Why First Choice VIP Care PLUS Was Created The Medicare Medicaid Plan, First Choice VIP Care PLUS, was created to
More informationKim 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
More informationCHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions...
TABLE OF CONTENTS SECTION PAGE NUMBER Background... 2 Policy... 2 535.1 Member Eligibility and Enrollment... 2 535.2 Health Home Required Functions... 3 535.3 Health Home Coordination Role... 4 535.4 Health
More informationProven Innovations in Primary Care Practice
Proven Innovations in Primary Care Practice October 14, 2014 The opinions expressed are those of the presenter and do not necessarily state or reflect the views of SHSMD or the AHA. 2014 Society for Healthcare
More informationTIPS Families of Children/Youth with special health Care needs (CYshCn) identifying CYshCn
TIPS Caring for a Child with Special Health Care Needs Partnering with Your Child s HEALTH PLAN Families of Children/Youth with Special Health Care Needs (CYSHCN) play a critical role in partnering with
More informationDavid Eubanks, RN, MSN Billie Papasifakis, RN-BC, MSN, AACC. Describe model of care most appropriate
THE BRIDGE PROGRAM David Eubanks, RN, MSN Billie Papasifakis, RN-BC, MSN, AACC Pamela Teenier, RN, MBA, COC-C, C HCS-D HCSD 1 Objectives Describe model of care most appropriate for a Bridge program from
More informationNational Clinical Programmes
National Clinical Programmes Section 3 Background information on the National Clinical Programmes Mission, Vision and Objectives July 2011 V0. 6_ 4 th July, 2011 1 National Clinical Programmes: Mission
More informationOpportunities for Home Care Providers in Working with Medical Homes October 2014. EMHS Vice President Continuum of Care Chief Advocacy Officer
How to Establish Partnerships and Opportunities for Home Care Providers in Working with Medical Homes October 2014 Lisa Harvey-McPherson, RN, MBA, MPPM EMHS Vice President Continuum of Care Chief Advocacy
More informationKeep Your Mind and Body Healthy: Understanding Mental Health Providers, Care and Coverage
Keep Your Mind and Body Healthy: Understanding Mental Health Providers, Care and Coverage Our mental health is a vital part of our overall well-being. It affects how we think, how we feel, and how we act.
More informationCase Management & Advocacy Services
Case Management & Advocacy Services Serving the Community since 1990 www.caregiverresourcecenter.com DBA The Caregiver Resource Center The Caregiver Resource Center s Commitment The Caregiver Resource
More informationSection 6. Medical Management Program
Section 6. Medical Management Program Introduction Molina Healthcare maintains a medical management program to ensure patient safety as well as detect and prevent fraud, waste and abuse in its programs.
More informationMedicare and Your Mental Health Benefits CENTERS FOR MEDICARE & MEDICAID SERVICES
CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare and Your Mental Health Benefits This is the official government booklet about Medicare mental health benefits for people in the Original Medicare Plan.
More informationThe 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
More informationCoventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business
Coventry Health Care of Florida, Inc. Coventry Health Plan of Florida, Inc. Coventry Health and Life Insurance Company Commercial Lines of Business Quality Management Program 2012 Overview Quality Improvement
More informationPlace of Service Codes for Professional Claims Database (updated November 1, 2012)
Place of Codes for Professional Claims Database (updated November 1, 2012) Listed below are place of service codes and descriptions. These codes should be used on professional claims to specify the entity
More informationMedical Management. Table of Contents: Procedures Requiring Prior Authorization. How to Contact or Notify Medical Management
Medical Management Table of Contents: Page 2 Page 2 Page 2 Page 2 Page 3 Page 7 Page 11 Page 11 Page 12 Page 12 At a Glance Procedures Requiring Prior Authorization How to Contact or Notify Medical Management
More informationPlace of Service Codes for Professional Claims Database (updated August 6, 2015)
Place of Codes for Professional Claims Database (updated August 6, 2015) Listed below are place of service codes and descriptions. These codes should be used on professional claims to specify the entity
More informationPresented 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
More informationEVIDENCE OF COVERAGE. A complete explanation of your plan. Health Net Green (HMO) January 1, 2010 December 31, 2010
EVIDENCE OF COVERAGE A complete explanation of your plan Health Net Green (HMO) January 1, 2010 December 31, 2010 Important benefit information please read H0755_2010_0389 10/2009 January 1 December 31,
More informationNursing Leadership from the Bedside to the Boardroom. Presentation ID: L13
Nursing Leadership from the Bedside to the Boardroom Presentation ID: L13 Disclosure Today s presenters do not have any relevant financial interests presenting a conflict of interest to disclose. Participants
More informationDeveloping Successful Hospital Partnerships
Developing Successful Hospital Partnerships Michael Logan, MHA Director of Operations Services Publication Date: May 2013 2013 Sawgrass Partners, LLC DEVELOPING SUCCESSFUL HOSPITAL PARTNERSHIPS Those aging
More informationPREVENTIVE CARE See the REHP Benefits Handbook for a list of preventive benefits* MATERNITY SERVICES Office visits Covered in full including first
Network Providers Non Network Providers** DEDUCTIBLE (Per Calendar Year) None $250 per person $500 per family OUT-OF-POCKET MAXIMUM (When the out-of-pocket maximum is reached, benefits are paid at 100%
More informationMODULE 11: Developing Care Management Support
MODULE 11: Developing Care Management Support In this module, we will describe the essential role local care managers play in health care delivery improvement programs and review some of the tools and
More informationVermont Blue 65. Coverage for Vermonters with Medicare. 2016 Medicare Supplemental Products. Group Brochure. An independent, local Vermont company
Vermont Blue 65 SM Coverage for Vermonters with Medicare 2016 Medicare Supplemental Products Group Brochure An independent, local Vermont company Three smart steps to quality health care after retirement:
More informationGet With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15
Get With The Guidelines - Stroke PMT Special Initiatives Tab for Ohio Coverdell Stroke Program CODING INSTRUCTIONS Effective 10-24-15 Date and time first seen by ED MD: The time entered should be the earliest
More informationType of Facility (As listed on License or Accreditation) Facility Demographics. Legal Business Name (as reported to the IRS):
Facility Credentialing and Recredentialing Application Please complete each section leaving no blank spaces. Clearly state if information requested is not applicable. Attach additional sheets when necessary.
More informationRehabilitation. Care
Rehabilitation Care Bruyère Continuing Care is the champion of well-being for aging Canadians and those requiring Continuing Care, helping them to become and remain as healthy and independent as possible
More informationThe Healthy Michigan Plan Handbook
The Healthy Michigan Plan Handbook Introduction The Healthy Michigan Plan is a health care program through the Michigan Department of Community Health (MDCH). Eligibility for this program will be determined
More informationGROUP MEDICARE. supplement plans
2016 GROUP MEDICARE supplement plans Create a Healthier Organization Your employees are your organization s most valuable asset. As they retire, you want to show your commitment to them and manage health
More information2015 plan comparison guide
2015 plan comparison guide Groups of 1 50 Plans available Jan. 1, 2015, through Dec. 31, 2015 Washington Better health starts here Hello. Welcome to Moda Health, the place you go when you want more than
More informationAcute Rehabilitation Center
Acute Rehabilitation Center Acute Rehabilitation Courtyard Our Center Community Westview Hospital's Acute Rehabilitation Center and programs are specially designed to meet the needs of our patients and
More informationNote: This article was updated on January 3, 2013, to reflect current Web addresses. All other information remains unchanged.
News Flash The Centers for Medicare & Medicaid Services (CMS) is listening and wants to hear from you about the services provided by your Medicare Fee-for-Service (FFS) contractor that processes and pays
More informationIEHP Care Management/ Care Coordination
IEHP Care Management/ Care Coordination Presented By: Dr. Brad Gilbert, CEO Inland Empire Health Plan 2 IEHP IEHP is a Joint Powers Agency, not-for-profit public entity that began serving Members September
More informationStatewide Medicaid Managed Care Managed Medical Assistance Program Update
Statewide Medicaid Managed Care Managed Medical Assistance Program Update Beth Kidder Assistant Deputy Secretary for Medicaid Operations Agency for Health Care Administration Presented to the KidCare Coordinating
More informationOBJECTIVES FACTS AND FIGURES CMS CHRONIC CARE MANAGEMENT 10/20/2015. Another Step Towards Care Coordination
CMS CHRONIC CARE MANAGEMENT Another Step Towards Care Coordination Care Coordination Patient/ Family Community Resources APARNA GUPTA, CRNP, MSN, PGDBA Transitions of Care Chronic Diseases OBJECTIVES AT
More informationORGANIZATIONAL ANCILLARY PROVIDER APPLICATION
ORGANIZATIONAL ANCILLARY PROVIDER APPLICATION Please complete each section thoroughly. Type or print clearly in black ink. Sign and date the application. YOU MUST INCLUDE THE FOLLOWING WITH THIS COMPLETED
More informationState of Payor Network and Reimbursement for Telehealth Services. Tim Maloney, UC Health Vice President of Payor Relations
State of Payor Network and Reimbursement for Telehealth Services Tim Maloney, UC Health Vice President of Payor Relations Introduction Reimbursement for services delivered via telehealth varies greatly
More informationUnderstanding 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;
More informationUtilization Review and Denial Management
September 2014 Clinical Resource Management Series Part 3 of 10 Utilization Review and Denial Management Part 3 in our Clinical Resource Management (CRM) series is focused on utilization review and denial
More informationUnderstanding Health Insurance
Understanding Health Insurance Health insurance can play an important role when it comes to medical bills and prescription medications it can help protect you from high expenses. There are many types of
More information