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.
Who Should Attend
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.