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Speaker |
Toni G Cesta |
Industry |
Nursing |
Speciality |
Nursing |
Calendar |
From: Sep 21, 2023 - To: Dec 31, 2023 |
Duration |
450 Minutes |
Description
The world of healthcare is changing rapidly and so is the role of case management in that world! Whether you are reading or hearing about value-based reimbursement, the Affordable Care Act, the continuum of care, bundled payments, transitions in care, or accountable care organizations, case management is at the center of it all!
Because things are changing so rapidly it can be a challenge to stay current and knowledgeable in the issues that most greatly impact your role as a case manager. Reimbursement has changed dramatically as has utilization management, transitional planning, and length of stay management. CMS has incorporated changes that impact payments related to readmissions, length of stay, and the cost of care. Who is in a better place to address these issues than case managers? Finally, how do all these roles come together in a cohesive way that meets the needs of your department and your organization?
All these topics and more will be covered in this jam-packed five-part series. Webinar 1 will start the series with some of the fundamental issues pertaining to case managers, including reimbursement systems, the history of case management, and common trends in the field. The next three webinars will review the three most imperative roles for acute case managers.
The first, in Webinar 2, will be a discussion of the role of utilization management, including rules, regulations, and strategies for incorporating utilization into your daily routine.
Webinar 3 will provide insights and up-to-date information on the role of discharge planning including new rules instituted in 2020.
Webinar 4 will provide an in-depth review of care coordination, a vital, but often forgotten role for hospital case managers.
We will end our series with Webinar 5, a discussion of how to integrate the roles and functions we have reviewed as well as a comparison of two state-of-the-art case management models. You will learn about the complimentary, but separate roles of RN case managers and social work case managers.
Whether you are new to case management or a seasoned pro, this webinar series will provide you with the latest and most up-to-date topics and information that you will need to be at the top of your game and produce the best outcomes for you, your patients, and your organization.
Foundations for Case Management Practice in 2023 and Beyond! Part-1
90 Minutes, 01: 00 PM EST (April 20, 2023)
Summary:-
Case management began moving into acute care settings around 1985 following the introduction of prospective payment. Today case management is found across the continuum of care, most recently returning to the community where its roots began. This program will review where case management came from and how it will work in today’s managed care and government-payer environments. Included will be a review of Medicare’s latest programs that impact the role of the case manager most directly including value-based purchasing, the readmission reduction program, accountable care organizations, and others. Take a glimpse into the future in this state-of-the-art review.
Objectives:-
After this webinar attendees will be able to:
Utilization Management: Rules, Regs and How To’s Part-2
90 Minutes, 01: 00 PM EST (April 21, 2023)
Summary:-
Utilization management was the first role applied in acute care case management models. It was first known as utilization review but has evolved into something much more comprehensive than that. Today it encompasses elements of resource management and denials management as well. Physicians, both the practicing physician and the physician advisor are often left out of this important process and must be included in any contemporary case management utilization management model. This program will review the role of utilization management as it applies to today’s contemporary case management models. Included will be best-practice suggestions for your practice with tips and strategies for streamlining the process and making it as efficient as it can be. Additionally, discussed with be the importance of utilization management collaboration in the case management role, whether it is housed with the RN case manager role or outside of it.
Objectives:-
After this webinar attendees will be able to:
Discharge Planning: Best Practices Including a Review of the Conditions of Participation Part-3
90 Minutes, 01: 00 PM EST (April 24, 2023)
Summary:-
Discharge planning has become more than just the movement of the patient out of the hospital. It is a “process” that starts at the point of admission and follows beyond discharge and through the continuum of care. The Centers for Medicare and Medicaid Services have proposed more “teeth” to the process, with updates to the discharge planning section of the Conditions of Participation. This program will review the most recent reimbursement challenges from the Medicare program as well as strategies for safely transitioning your patients across the continuum of care. Effective discharge plans can improve your hospital’s value-based reimbursement. We will review how to engage other members of the interdisciplinary care team in the process of planning for the patient’s movement across the continuum including verbal and written hand-off communication. Discharge planning is no longer a destination but a process! Learn how to be certain that your processes address the complexities of the new healthcare environment.
Objectives:-
After this webinar attendees will be able to:
Care Coordination: Managing Cost and Length of Stay Part-4
90 Minutes, 01: 00 PM EST (April 25, 2023)
Summary:-
You may spend most of your day focusing on utilization management and discharge planning, but care coordination is one of the key roles that hospital case managers and social workers perform. Other roles include utilization management and discharge planning. It is integral to managing cost and length of stay. Nevertheless, it is often overlooked or under-performed. This is sometimes due to workload issues and/or understaffing. Other times it is due to a lack of focus on this area of work.
This program will review the elements that most greatly impact cost and length of stay. By focusing on care coordination as one of the key strategies for successful reductions of these metrics, you will be better positioned to perform your role as a hospital case manager. Care coordination, as one of the main roles of the RN case manager, is complex and includes many characteristics that encompass the role. Although these issues can be complex, there are tools and techniques to incorporate care coordination into your daily practice. These will be covered as well as those elements that have the greatest negative impact on care coordination. Those that have the greatest positive impact will be discussed in detail. Working with teams to enhance care coordination, as well as rounds and huddles, will be discussed. Participants will walk away with effective strategies for managing their hospital’s length of stay and cost.
Objectives:-
After this webinar attendees will be able to:
Acute Care Case Management: Roles, Functions, and Models Part-5
90 Minutes, 01: 00 PM EST (April 27, 2023)
Summary:-
As case management moved into acute care settings the roles and functions of both RN case managers began their evolution. From the time of the UR specialist sitting in the corner of a nursing station reviewing a record for medical necessity to appease the state physician review organization to the current role of the RN case manager involved in multidisciplinary collaboration, the roles have changed significantly.
This program will review the contemporary roles of both RN case managers and social work case managers, in addition to clerical support and more complex case management roles, such as the complex discharge planner. Evaluate your roles and functions, as well as the roles and functions of your department in this informative seminar.
As case management roles and functions evolved, so did case management models. From a model with social work support to a model without that critical support, case management leaders and hospital executives have been challenged to ensure a best practice model that lends itself to the most optimal outcomes.
Learning Objectives
Objectives:-
After this webinar attendees will be able to:
This webinar benefits the following:
Who Should Attend
(Ph.D., RN, FAAN)
Toni G. Cesta, Ph.D., RN, FAAN is a founding partner of Case Management Concepts, LLC, a consulting company that assists institutions in designing, implementing, and evaluating case management models in the acute care, emergency department, and outpatient settings. Dr. Cesta writes a monthly column called “Case Management Insider” in the Hospital Case Management newsletter in which she shares insights and information on current issues and trends in case management.
Dr. Cesta has held positions as Senior Vice President – Operational Efficiency and Capacity Management at Lutheran Medical Center in Brooklyn, New York where she was responsible for case management, social work, discharge planning, utilization management, denial management, bed management, the patient navigator program, the clinical documentation improvement program, and systems process improvement.
Dr. Cesta has a BS in Biology from Wagner College, a BS in Nursing from Adelphi University, an MA in Nursing Administration from New York University, and a Ph.D. in Nursing Research and Theory Development from New York University. Dr. Cesta is a Fellow of the American Academy of Nursing.