Managing Length of Stay: Case Management’s Response to the New Value-Based Purchasing ‘Efficiency Measure’

Event Information
Product Format
Prerecorded Event
Toni G. Cesta, Ph.D., RN, FAAN
60 minutes
Product Description

Efficiency Measure: The New CMS Element for Health Care Reform

As one of the elements of healthcare reform, The Centers for Medicare and Medicaid Services (CMS) has implemented a course of action aimed at bringing Medicare to a break-even budget. The elements that we are now familiar with include the ‘clinical processes of care’, ‘outcomes’ (which include readmissions, deaths and complications), ‘the patient experience of care’, and now the “efficiency measure”. The “Spending per Medicare Beneficiary Measure” or the ‘efficiency measure’ brings much of the work of case management to the surface yet again. This measure focuses on length of stay and spending per a beneficiary episode, two elements that case management plays a critical role in controlling and managing.

Medicare’s purpose in applying this measure is to encourage hospitals to be more cost efficient by providing financial incentives to hospitals based on their performance. In this session, expert speaker Toni G. Cesta, Ph.D., RN, FAAN, will discuss the response of case management to the new value-based purchasing efficiency measure.

Session Highlights

  • The value-based purchasing domains and measures
  • The definition and scoring used for the CMS efficiency measure
  • Care coordination’s impact on length of stay and cost
  • Five key elements of care coordination
  • Elements impacting on length of stay
  • Strategies for evaluating your hospital’s own areas of inefficiency

Session Agenda

  • Supreme Court ruling on healthcare reform
  • Value-based purchasing domains and measures
  • Efficiency measure
  • Medicare spending per beneficiary
  • The 4 functions of case management
  • 5 key elements of care coordination
  • Care coordination and discharge planning
  • Transitional planning
  • LOS strategies
  • Care coordination documentation
  • Assess your department's effectiveness
  • Characteristics of effective case manager as care coordinator
  • Case management overview
  • Healthcare reform strategy

Who Should Attend

  • Director of case management
  • Case managers
  • Directors of nursing
  • Directors of patient flow
  • Director of revenue cycle
  • Chief financial officers
  • Chief operations officers
  • Chief medical officer
  • Hospitalists
  • Director of quality management
  • Nursing home directors
  • Director of home care

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About Our Speaker

Toni G. Cesta - Healthcare Case Management Expert

Toni G. Cesta, Ph.D., RN, FAAN is Partner and Health Care Consultant in Case Management Concepts, LLC, a consulting company which assists institutions in designing, implementing and evaluating acute care and community case management models, providing on-site education to case management staff, and strategies for assisting health care organizations in improving their case management department’s efficiency and effectiveness.

The author of nine books, and...   More Info
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