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![Page 1: Positively impacting and improving patient wellbeing and health care outcomes. Case Management Exhibitor Information What Exhibitors Should Know About.](https://reader035.fdocuments.in/reader035/viewer/2022062800/56649dff5503460f94ae73f9/html5/thumbnails/1.jpg)
Positively impacting and improving patient wellbeing and health care outcomes.
Case ManagementExhibitor InformationWhat Exhibitors Should Know About CMSA
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Positively impacting and improving patient wellbeing and health care outcomes.
Case Management Definition
CASE MANAGEMENT is a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes.
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Positively impacting and improving patient wellbeing and health care outcomes.
Primary Work Settings
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Positively impacting and improving patient wellbeing and health care outcomes.
One Job – Many Duties
• Pre-certification• Benefit Determination• Risk Management• Medical Legal Consultation• Life Care Planning• Disease Management• Utilization Management• Case Management• Discharge Planning• Health & Wellness Coaching• Research• IT or Data Services
• Direct Patient Care/Education• Product Development• Disability Management• Negotiation – contracts & fee
schedules• Telephonic/On-site Case
Management• Medication Therapy
Management• Education – patient, provider,
& staff• Accreditation • Telephonic Demand
Management
Question: What Tasks Are Currently Included in Your Job Duties?
Source: CMSA 2007 State of the Industry Survey
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Positively impacting and improving patient wellbeing and health care outcomes.
Industry Issues
• Health Care Reform• Care Coordination• Transitions of Care• Patient Safety• Medication Reconciliation• Payment Alignment & Performance Measures• New Models of Care• Patient & Family Caregiver Engagement• Collaborative Practice
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Positively impacting and improving patient wellbeing and health care outcomes.
Patient
ER ICU
In-Patient
Patient
OUTPATIENT:• Home• PCP• Specialty• Pharmacy• Case Mgr.• Care Giver
SNF ALF
EDCase Mgr
HospitalCase Mgr Managed
CareCase Mgr
Continuum Case Mgrs
Transition Issues DramaticallyImpact Patient Care
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Positively impacting and improving patient wellbeing and health care outcomes.
We Serve Many People Along the Health Care Continuum
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Positively impacting and improving patient wellbeing and health care outcomes.
One Job – Many NamesMY JOB TITLE IS:– Case Manager– Care Manager– Care Coordinator– Discharge Planner – Disease Manager – Department Supervisor – Department Manager – Department Director– Utilization Manager– Other
• Social Worker• Senior Care/Rehab • Occupational Nurse
Source: CMSA 2007 State of the Industry Survey
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Positively impacting and improving patient wellbeing and health care outcomes.
CMSA Standards of Practice:
• Evolution of the SOP• Definition of CM• CM Practice Settings• CM Roles, Functions,
Activities• Components of the CM
Process• Standards of Practice• Glossary and Acronyms• References
Currently
under revision
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Positively impacting and improving patient wellbeing and health care outcomes.
Today’s Case Manager
• Today, case managers are in most elements of the payer and provider communities where the need to balance quality care and cost-effective care exists.
• The process of case management begins with identification of high-cost, complex care individuals who meet criteria for and can benefit from case management services
Source: CMSA Standards of Practice
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Positively impacting and improving patient wellbeing and health care outcomes.
Healthcare Reform – On The Horizon
• Baucus Call to Action – Strengthening the role of Primary Care and Chronic Care Management
• H.R. 2773 – Supports the Transitional Care Model• The Senate Health, Education, Labor and
Pensions (HELP) Committee released a “draft of a draft” of healthcare reform legislation. – Group and individual health insurers must implement
a reimbursement structure that provides incentives for:• The implementation of case management, care coordination,
and chronic disease management activities for treatment or services under the plan;
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Positively impacting and improving patient wellbeing and health care outcomes.
Collaborative Care, Care Coordination and Transitions of Care Models
• Dr. Eric Coleman – Transition Coaching• Dr. Mary Naylor – Transitional Care Model• Dr. Chad Boult – Guided Care Nurses• Medical Home Demonstration • National Transitions of Care Coalition (NTOCC)• American Geriatric Society• National Coalition on Care Coordination (N3C)
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Positively impacting and improving patient wellbeing and health care outcomes.
DevelopingCare Coordination Measures
• CMS 9th SOW supports Care Coordination– Care Pathways
• 2009 TJC Patient Safety Standard #8 enhanced Medication Reconciliation to include patient and caregiver involvement and transition– Documentation of process
• NQF developing Performance Measures for Care Coordination– Call for Best Practices December 2008– Measures Development in 2009
• URAC incorporating TOC principals in revised CM Standards
• AMA – PCPI Transitions of Care – ACP/SHM/ABIM Foundation/PCPI will develop jointly practitioner-level
performance measures for transitions of care
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Positively impacting and improving patient wellbeing and health care outcomes.
The Continuum of CareClinical & Administrative Transactions
Pharmacy Employer
Physician Office
Specialist
Case Manager
Hospital
Community HealthCenter
PBM
Patient
AdherenceAssessment & Support
Health Promotion
Motivational Advocacy
Prescr
iption
Assessm
ent &
Care
Plan
Motivational InterventionsAdvocate
Assessment
Medication Reconciliation
Care Plan
AdherenceAssessment & SupportCoordination
Non-Adherence
Behavior Health Change
Facilitation
Increase Productivit
y
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Positively impacting and improving patient wellbeing and health care outcomes.
Case Management Society of AmericaCONNECTING YOU TO CASE MANAGERS
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Positively impacting and improving patient wellbeing and health care outcomes.
Expanding Our Reach• Currently approaching 12,000
members– Additional 15,000 subscribers– Over 200 company members– 75 geographic chapters
• Presence across the continuum– 34% in managed care/insurance– 26% in acute care/hospital setting– 12% in work comp/occupational
health/employers– 9% in government
agencies/military
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Positively impacting and improving patient wellbeing and health care outcomes.
Reaching Case Managers Year-Round
• Educational opportunities and events– In-person and on-line– With or without continuing education credits
• Tools and resources
• Increasing knowledge and case management effectiveness
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Positively impacting and improving patient wellbeing and health care outcomes.
COURSEWORK LEVELS
• Basic• Intermediate• Advanced
• FREE CE and Non-CE Courses (CM/DM/UM)• My Coursework• Masters Level Coursework • Other Resources• Business Courses
INCLUDED IN MEMBERSHIPCMSA’s online educational
resource offers programs to care managers and allied health professionals serving the care
management industry.
Educational Research Library
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Positively impacting and improving patient wellbeing and health care outcomes.
Case ManagementAdherence Guidelines
• Adherence Assessment• Motivational Interviewing• Follow-up• Using:• Accessible Material• Focused Learning• Tools and Resources
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Positively impacting and improving patient wellbeing and health care outcomes.
Growth of CMAG• Currently in second revision• In 2006, launched first
disease specific supplement:– Diabetes– DVT– Depression – Cardio metabolic risk– COPD (in development)
• Translated into three languages
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Positively impacting and improving patient wellbeing and health care outcomes.
Resource Paths
• Guides used by case managers to help navigate assessment, treatment and intervention
• Designed to be mentoring and “as needed” training devices
• Can incorporate new clinical, assessment and intervention methods
• Advocate to the health care team
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Positively impacting and improving patient wellbeing and health care outcomes.
Corporate Partnership
• Access to attendee and membership lists
• Discounts for exhibit booths and other CMSA products
• Complimentary individual memberships and conference registrations
• Heightened visibility
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Positively impacting and improving patient wellbeing and health care outcomes.
2010 Annual Conference & Expo
CMSA’S 20th ANNIVERSARYJune 8 – 11, 2010
Walt Disney WorldCoronado Springs Resort
Orlando, Florida
www.cmsa.org/conference
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Positively impacting and improving patient wellbeing and health care outcomes.
New Outreach Opportunities
• Educational and Promotional Events– CE Symposia– Non-CE Symposia
• General Conference Sponsorships– 12 months of promotion• Website• Print material• E-communications
– Signage and recognition
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Positively impacting and improving patient wellbeing and health care outcomes.
Partnering With Disney• Coast-to-Coast Party
Kick-Off Event– Exclusive use of Disney’s Hollywood
Studios– Unique branding and promotion
opportunities– Exclusive and wide-spread promotion
of sponsors• Disney’s Exhibitor
Concierge Service– Theme Park Events & Tickets– Entertainers– Cutting edge AV and booth
presentations
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Positively impacting and improving patient wellbeing and health care outcomes.
• EXHIBIT BOOTHS: contact the Exhibit Management Team for more information
• SPONSORSHIPS:available for all budgetsand guidelines
• STRATEGIC PACKAGES
Conference Opportunities
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Positively impacting and improving patient wellbeing and health care outcomes.
Key Contacts
• MICHELLE KOCHDirector, Corporate [email protected]
• LINDSAY HARPAccount [email protected]
• J. MICHAEL HOEHNVice-President,Business [email protected]
• HARRY ALBACorporate [email protected]
• SYLVIA JOHNSONConference [email protected]
• SHELLY GREENWOODEvent [email protected]
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Positively impacting and improving patient wellbeing and health care outcomes.
Thank You for Your Supportof Case Management