As one of the elements of health care 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 familiar elements include the ‘clinical processes of care’, ‘outcomes’ (which include readmissions, deaths and complications), ‘the patient experience of care’, and now the “efficiency measure”. Much of the work of case management is within the limelight again with the “Spending per Medicare Beneficiary Measure” or the ‘efficiency measure’. 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.
By applying this measure, Medicare aims to encourage hospitals to be more cost efficient by providing financial incentives to hospitals based on their performance. CMS also hopes to increase the transparency of care for consumers and recognize hospitals that are involved in providing high quality care at lower cost. This session with expert speaker Toni Cesta, Ph.D., RN, FAAN will help you understand the new measure and its impact on improving length of stay and cost per case.
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.