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What is one key role of case management in the current healthcare system?
Case management is on the front line of necessary change to address fragmentation in healthcare delivery.
How has the Affordable Care Act (ACA) affected case management?
The ACA has expanded the role of case management within its initiatives, making care coordination more integral.
What is the definition of case management according to the CMSA?
Case management is defined as a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet health needs.
What historical context is provided regarding case management?
Case management has been documented in various forms in the U.S. since the early 1900s, with strong roots in community and public health.
What were the outcomes of community-based nurse case management interventions for Medicare clients?
Such interventions resulted in lowered costs and reduced emergency department encounters and inpatient days.
What is predictive modeling (PM)?
PM is a tool used to identify clients at high risk for hospital admission and improve care coordination.
List two critical skills required for effective case managers.
Effective case managers should have clinical expertise and critical thinking skills.
What is the relationship between case management and the nursing process?
Case management parallels the nursing process, focusing on individual holistic care.
What are the standards of practice for case management established by the CMSA?
These include client selection, assessment, problem identification, planning, monitoring, and evaluation among others.
Name one initiative of the ACA that involves case management.
Medicare ACOs proposing quality measures that link shared savings for improved care coordination.
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