Source: CMSA Today By TIFFANY FERGUSON, LMSW, CMAC, ACM The Age-Friendly Hospital Rating, introduced as part of the CMS 2025 Inpatient Prospective Payment System (IPPS) Final Rule (HHS, 2024), highlights an opportunity for case managers to play a pivotal role in enhancing care for older adults. The new structural measure is designed to assess hospitals’ […]

Source: CMSA Today BY PAUL BORJA, RN, DNP, EdD, PhD, PHN, CCM, ACM-RN, CMAC, CMCN, CNML, CMGT-BC, CDONA, FACDONA, FAACM Healthcare decision-making is always optimal when coming from the patient. However, if the patient cannot make those decisions, a surrogate decisionmaker would be the following route to obtain medical decisions for care planning. But what

Source: CMSA Today BY LOREN TALBOT, INELDA’S DIRECTOR OF PARTNERSHIPS AND COMMUNICATIONS The death positive movement of the past decade has ushered in a new wave of death awareness and willingness to discuss and plan for end-of-life. Along with that wave has come the accession of end-of-life doulas, also known as death doulas or death

Source: CMSA Today BY CATHERINE DURKIN ROBINSON When most people think of doulas, they think of non-medical professionals helping to facilitate the birth of babies. And they’d be right! But there are other kinds of doulas, too. The term “death doulas,” mostly women caregivers for the dying, who have existed in some capacity since the

Source: CMSA Today BY PEGGY A. ROSSI, BSN, MPA – AUTHOR AND RETIRED RN/PHN, CCM, ACM-RN, CMAC I have long considered case managers as the ICU of a healthcare organization’s revenue cycle. As the “silver tsunami” hits your organization, we may all need to think about what we might have to do to preserve our

Source: CMSA Today BY DR. HEAVEN PROVO, MBA, DNP, RN, CCM, PHNA-BC, NE-BC, LNFA, CAHIMS, FCM I wear many hats: wife, mom, bonus mom, sister, daughter, and friend…all of which take priority for me. I would like to start by acknowledging my supportive family and God’s grace for every season. Where do I begin? Is

Source: CMSA Today BY HEIDI SCARBROUGH, RN, CMSRN, CCM, NE-BC End-stage renal disease (ESRD) consistently ranks among the top 10 catastrophic stop-loss claims for reinsurance carriers. According to the most recent Sun Life report, it ranked #10, with reimbursements totaling $54.3 million in 2022 (SunLife, 2023). The report indicates that 71% of all stop-loss claims stem

Source: CMSA Today BY LISA SIMMONS-FIELDS, DNP, MSA, RN, CCM, CPHQ, FCM, AND MAUREEN PIKE, MPH, MBA, RN INTRODUCTION For the past three years, Trinity Health’s Clinically Integrated Networks (CIN), Community Health & Well-Being (CHWB) departments and the Medical Groups (THMG) have engaged in a national strategy for reducing preventable hospitalizations among Medicare Shared Savings Program (MSSP)