BY GARRY CARNEAL, JD, MA The U.S. medical system is dynamic and always evolving. Understanding the regulatory landscape is essential for case managers to optimize their patient-centered mission. Simply put, a basic knowledge of the laws and regulations applicable to the jurisdiction that case managers work in and the programs they support is important to […]
BY REBECCA PEREZ, MSN, RN, CCM Everyone aspires to provide quality healthcare. The definition of healthcare quality would seem straightforward; however, establishing metrics is not necessarily so straightforward, a point recognized by Avedis Donabedian, a Lebanese physician and founder of the study of healthcare quality over half a century ago. In 1966, Dr. Donabedian recommended […]
BY MELANIE A. PRINCE, RN, BSN, MSN, NE-BC, CCM, FCM, FAAN This issue of CMSA Today is a compilation of articles, editorials and resources about legal considerations in healthcare. I recently attended a Health Equity Summit with leaders from a variety of sectors, including law, government, healthcare, academia, public health and community advocacy. These professionals […]
Registration Now Open for the 2023 CMSA Annual Conference: DISCOVERING SOLUTIONS, DRIVING CHANGE CMSA’s conferences are unparalleled with top-notch education, inspiring content, industry vendors and experts, professional connections and lasting friendships made. The list could go on and on! Register today to join us for the CMSA Annual Conference June 27-30, 2023, at the Mandalay […]
BY SHERRY ALIOTTA, BSN, RN-BC, CCM The Standards of Practice for Case Management have been updated. The newly revised standards need not be a reference volume or an unrealistic ideal. They represent a philosophy, statement of beliefs, values to guide a program, its context and the role of the individual(s). They can serve as a […]
BY VALERIE LINZEY, DNP, APRN, FNP-C Primary care practices are faced with many challenges when their patients are admitted or visit an outside facility or hospital. One of the major problems is a breakdown of communication when patients are discharged from the health facility or hospital and need to follow with primary care. Evidence suggests […]
BY DR. COLLEEN MORLEY, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM INTRODUCTION Are we there yet? As we come to the final installment of my Electronic Road Trip series, I hope you have found some great new resources and revisited familiar ones with new perspective. Continuing my review of some excellent repositories of knowledge dedicated to […]
BY MARY PAQUETTE, RN, BSN, CCM, AND MELINDA BAXTER, RN, MSN, CCM Gene therapy is the latest high-cost challenge facing health plans and reinsurers alike. The need to understand issues associated with treatments, medical management, network management and contracting will evolve and persist. Take, for example, when organ transplantation networks first came on the scene. […]
BY DR. COLLEEN MORLEY, DNP, RN, CCM, CMAC, CMCN, ACM-RN, FCM Digital technologies are electronic tools, systems, devices and resources that generate, store or process data. Social media, online games, multimedia, patient portals and “apps” are just a few examples on how healthcare has leveraged digital technologies. Digital technology links to digital learning, which is any […]
