Beyond Basics of Case Management Boot Camp, Part 2-2024 Beyond Basics of Case Mgt Part 2 Recording

Video Transcription

Video Summary

Dr. Tony Sesta, a case management consultant, discusses the importance of proper case management in healthcare settings, focusing on the two-midnight rule for inpatient stays and managing patient admissions. Emphasizing the role of case managers in ensuring compliance with medical necessity and providing alternative care options, she addresses the self-denial process for Medicare patients and the changing landscape of inpatient-only services. Access point case management is highlighted for optimizing patient care and hospital reimbursement. The transcript also covers the proactive roles of case managers in pre-admission and emergency department settings, stressing early intervention, discharge planning, and collaboration with healthcare providers to reduce readmissions. Registered nurses and social workers play vital roles in assessing patient needs and addressing social determinants of health. Measurements for program success include admission denials, readmissions, length of stay, patient satisfaction, and physician satisfaction. Collaboration between RN case managers and social workers is crucial for providing comprehensive patient care.

Keywords

Dr. Tony Sesta

case management consultant

healthcare settings

two-midnight rule

patient admissions

medical necessity

alternative care options

Access point case management

patient care optimization

collaboration

readmissions

social determinants of health

program success measurements

RN case managers