Source: CMSA Today BY MICHELLE BRUSIO, MSN, RN, CCM One of my favorite guilty pleasures is collecting and enjoying Charles Schulz’s Peanuts. From the earliest comic strips to the beloved television specials and treasured collectibles, some classics truly stand the test of time. Each character was inspired by someone in Schulz’s life, and together the
Peanuts and Case Managers Read More »
Source: CMSA Today BY HEIDI STEINHEBEL, RN BSN CCM Hypertension impacts Black African Americans 26% more often than other racial/ethnic groups, and approximately 83% of Black adults with high blood pressure do not have it under control, even while on medications. Deaths related to high blood pressure occur twice as frequently in Black Americans compared
Every Heart Matters: Empowering Underserved to Manage High Blood Pressure Read More »
Source: CMSA Today BY CATALINA KHALAJ, PMHNP-BC, MSN, RN, CCM, ACM, CMGT-BC—A case manager with experience across ambulatory care, acute care, managed care, and population health. ABSTRACT In an era of unprecedented technological advancement, professional case managers stand at the intersection of innovation and compassion. Artificial intelligence (AI) and digital tools offer powerful capabilities to
Source: CMSA Today BY JANET COULTER, MSN, MS, RN, CCM, FCM INTRODUCTION Mention utilization management (UM), and many healthcare professionals immediately think of prior authorizations, medical necessity reviews, documentation requirements, and coverage determinations. It may not be the most glamorous area of healthcare, but utilization management sits at the very heart of ensuring patients receive
Beyond the Authorization: Navigating the Evolving Challenges of Utilization Management Read More »
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)
ACCESS and the Future of Chronic Care: CMSA Helps Define the Role of Case Management Read More »
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
The Heart of Leadership Read More »
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
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
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
Bridging Adolescence and Adulthood: Case Management for Transitional-Age Young Adults Read More »
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
