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

Understand the CMS’s New Value-Based Purchasing Efficiency Measure and its Impact on Length of Stay and Cost per Case

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.

Session Highlights:

  • Understand the new value based purchasing efficiency measure
  • Identify key strategies for managing case management’s impact on the new measure
  • Learn about your hospital’s own efficiency measure and what it means.
  • Strategies for evaluating your hospital’s own areas of inefficiency.
  • Develop an effective team for collaboration to efficiently manage length of stay across the continuum of care.
  • Understand how cost across the continuum affects your hospital’s cost per case.
  • Understand how your case management department may have the biggest impact on reducing your cost and length of stay.
  • How do you know your efficiency score?
  • Why do we care about Length of Stay?
  • 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 length of stay.

Session Snapshot:

  • Supreme Court ruling on healthcare reform: 7 imperatives for finance execs
  • The value-based purchasing domains and measures
  • Medicare spending per beneficiary measure scores
  • Who impacts Medicare spending per beneficiary
  • The 4 functions of case management
  • 5 key elements of care coordination
  • What impacts expected Length of Stay?

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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