Reimbursement changes coming--CMs key to meet payer requirements.

Case managers can have a big impact their hospital's bottom line when the Centers for Medicare and Medicaid Services (CMS)begins rolling out initiatives that will reimburse hospitals for the value of the services they provide, in addition to volume. Start now to learn about the new reimbursement initiatives and work with quality staff and physicians to determine what issues need to be addressed. Take a proactive approach to discharges. Ensure patients understand their treatment plans and that there is a smooth transition to the next level of care. Hospitals with excess readmissions for heart failure, pneumonia, and acute myocardial infarction (AMI) will receive reduced reimbursement. Medicare will start tracking spending per-beneficiary for the entire episode of care, beginning three days before admission through 30 days after discharge.