Beyond Basics of Case Management Boot Camp, Part 5-2024 Beyond Basics Case Mgt Part 5 Presentation

2024 Beyond Basics Case Mgt Part 5 Presentation

Pdf Summary

The document outlines the key concepts of case management outcomes and the importance of defining key performance indicators. It emphasizes the need for measuring program effectiveness and demonstrating value in healthcare. Various metrics are discussed, including financial, clinical, and service benchmarks, aiming to improve case management performance. The role of physician advisors in managing denials and length of stay is highlighted, with examples of tracking financial and clinical metrics provided.<br /><br />Efficiency measures and the impact on Medicare spending per beneficiary are explained, along with tracking avoidable days and delays in care delivery. The document also delves into the readmission reduction programs and penalty adjustments, underlining the need for risk adjustment and inclusivity criteria.<br /><br />A comprehensive overview of setting up case management report cards, measuring staff performance, and turning data into actionable insights is provided. Strategies for improving outcomes, including understanding key indicators, managing workloads, and incorporating new knowledge, are detailed. The importance of data-driven decision-making and resource optimization is emphasized throughout.<br /><br />In conclusion, the document stresses the relevance of data in proving value and making informed decisions within case management. It encourages active involvement in outcomes, long-term commitment to solutions, and continuous learning and adaptation to enhance performance. Various resources and additional references are listed for further exploration of the discussed topics.

Keywords

case management outcomes

key performance indicators

program effectiveness

healthcare value

physician advisors

financial metrics

clinical benchmarks

efficiency measures

Medicare spending

readmission reduction programs