Part Four: Case Management Boot Camp 2026: Fundamentals for Everyday Practice (PT4W6013)-Case Management Boot Camp 2026, Part Four Presentation

Case Management Boot Camp 2026, Part Four Presentation

Pdf Summary

The document explains how care coordination is central to hospital case management and directly affects cost, length of stay (LOS), patient outcomes, and value-based performance. Care coordination is defined as organizing care activities and sharing information so the right care happens at the right time. In hospitals, case managers help manage utilization, avoidable delays, discharge planning, readmissions, and psychosocial needs.<br /><br />A major focus is controlling LOS, since it affects reimbursement, efficiency, public reporting, and value-based purchasing. Expected LOS depends heavily on accurate documentation and coding, while actual LOS is shaped by patient flow, physician practice patterns, consultant timeliness, availability of services, discharge planning, and post-acute resources. Effective resource management requires evidence-based use of services, staffing, and supplies, along with real-time and prospective planning.<br /><br />The presentation also emphasizes measuring cost and value. Cost accounting systems help track the true cost of care and support negotiations, cost reduction, and analysis of outcomes. Value in healthcare is defined as health outcomes achieved per dollar spent, and Medicare’s value-based purchasing program ties payments to outcomes, safety, patient experience, and efficiency.<br /><br />Patient flow is presented as a key operational tool across access, throughput, and discharge. Delays can occur in the ED, lab, radiology, pharmacy, transport, surgery, and discharge processes, often increasing LOS and costs. The presentation highlights avoidable delay tracking as a practical tool for identifying who caused a delay, why it happened, and how many days were lost. This data can be used to improve processes, justify service changes, and reduce unnecessary hospital days.<br /><br />Finally, the document underscores the importance of coordinating with patients, families, caregivers, and post-acute providers to support safe transitions, reduce readmissions, and improve outcomes.

Keywords

care coordination

hospital case management

length of stay

utilization management

discharge planning

readmissions

cost accounting

value-based purchasing

patient flow

avoidable delays