ACCESS and the Future of Chronic Care: CMSA Helps Define the Role of Case Management

Source: CMSA Today When the Centers for Medicare & Medicaid Services (CMS) introduces a new care delivery model, healthcare organizations begin asking how they’ll implement it. CMSA asked a different question: Where does professional case management fit? That question inspired the development of CMSA’s new position paper, Advancing Chronic Care with Effective, Scalable Solutions (ACCESS) […]

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The Heart of Leadership

Source: CMSA Today BY JANET COULTER, MSN, MS, RN, CCM, FCM There are moments in life when you accept an opportunity knowing it will challenge you. Then there are moments that change you forever. Serving as president of the Case Management Society of America has been one of those moments. When I accepted the privilege

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Interdisciplinary Teamwork Using Care Coordination and Integrated Case Management (CCICM): The Key to Breaking Traditional Health Care Silos

Source: CMSA Today BY ANGELA SIMMONS, MSW, LCSW, CCM AND BINA STITT, MPA, MSN, RN, CCM Back in 2016, two major VA offices— Offices of Nursing Services (ONS) and Care Management and Social Work (CMSW)—teamed up for something big: the Integrated Case Management Initiative. The goal was to take a hard look at how we handle

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Internal Authorization, External Impact: A Case Management Innovation to Reduce Length of Stay and Improve Throughput

Source: CMSA Today BY COLLEEN MORLEY, DNP, RN, CCM, CMAC, CMGT-BC, CMCN, ACM-RN, FCM, FAACM Delays in payer authorization for post-acute services remain one of the most persistent—and often underappreciated—drivers of prolonged hospital length of stay (LOS). While clinical teams may achieve medical readiness for discharge, patients frequently remain hospitalized due to administrative barriers outside of

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Bridging Adolescence and Adulthood: Case Management for Transitional-Age Young Adults

Source: CMSA Today BY HEATHER KELLY, MSN, RN, BCPA, CPC A child’s eighteenth birthday marks an abrupt and consequential transition, not only socially but legally, transforming a dependent minor into an autonomous adult overnight. In healthcare, this legal reclassification can fracture continuity of care, abruptly limiting parental access to medical information, decision-making authority, and coordination roles

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Optimizing Hospital Throughput Using Direct Bill Skilled Nursing Facility Partnerships: A Three-Year Review of the OhioHealth-Laurels Healthcare Model

Source: CMSA Today BY JACQUELINE (JACQUI) BASTIAN, BSN, RN, MSOL, CCM, KATE COFFIELD AND AMY CAMPBELL-TUMBLIN EXECUTIVE SUMMARY In early 2023, OhioHealth and The Laurels Healthcare launched a direct-bill, contracted-bed model to safely transition medically stable, long-stay patients with significant discharge barriers from acute care to skilled nursing facilities (SNFs). Over three years, the partnership improved hospital throughput, protected

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From Strategy to Structure: Developing a Heart Failure Care Management Program

Source: CMSA Today BY HEIDI STEINHEBEL, RN, BSN, CCM Heart failure represents a significant national health crisis, accounting for more than one million hospitalizations annually in the United States. The condition affects approximately one in four individuals over their lifetime, with the prevalence expected to increase from 6.7 million Americans today to 8.5 million by 2030.

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The Art of Advocacy

Source: CMSA Today BY DR. JENNIFER GAZDA, LCSW, NCG, CMC, CDP As case managers, we have the opportunity to provide insightful and supportive care to patients in a variety of roles and settings. While a large proportion of case managers are nurses and social workers, many ancillary professionals also have found themselves serving in the capacity

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Advocacy in Case Management at the End of Life

Source: CMSA Today BY HUSSEIN MICHAEL TAHAN, PhD, RN, FAAN, FCM Advocacy is a defining function of professional case management. It assumes heightened importance at the end of life, when patients and families must navigate complex decisions, emotional distress, and fragmented care systems. Strengthening advocacy capacity among professional case managers is essential to promoting patients’ dignity,

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