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12/10/09 Edition:
A Monthly e-Newsletter for Hospital/Health System
Case Management Professionals
from the American
Case Management Association
ACMA Members Receive More - This e-Newsletter is only a partial representation of our weekly member e-Newsletter; membership gains you access to the full version of briefCASE and many member-only benefits such as research data (the only national source of 95% confidence level hospital case management research), quarterly peer-reviewed publication, conference discounts, and online networks for peer information exchange. Join ACMA to receive the full information weekly.
Connolly Announces RAC Review Issues CMS to Continue PEPPER Reports in January
Uninsured ED Patients Twice as Likely to Die Inpatient Satisfaction on the Rise
CMS Open Door Forums 2010 NICM/ACMA National Conference
ACMA Leadership Webinar Series ACM™ Certification Application Deadline Reminder
 
Healthcare News & Legislative Update
Healthcare News & Legislative Update
Connolly Announces First Issues for Complex RAC Review
Connolly Healthcare, the Recovery Audit Contractor (RAC) for Region C, has announced the first issues approved by the Centers for Medicare and Medicaid Services (CMS) for complex RAC review. The DRG-validation issues are approved for the following states: Alabama, Colorado, Florida, Georgia, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, and Texas. The Connolly website lists 24 approved DRG validation issues, including: major chest procedures with major complication/comorbidity (MCC) and respiratory system diagnosis with ventilator support for 96 or more hours. - read more...
   
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Case Management Jobs

Director Clinical Review
Blue Cross and Blue Shield
of Florida
Jacksonville, FL
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Regional Vice President,
Case Management

Baptist Health System
San Antonio, TX
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Registered Nurse Lead
Beaver Dam
Community Hospitals, Inc.
Beaver Dam, WI
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Case Manager
Advanced Clinical
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Oneonta, AL
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Utilization Review Coordinator
Hennepin County
Medical Center
Minneapolis, MN
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Director Medical
Management Operations

Centene Corporation
St. Louis, MO
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Care Management Director
Baystate Health
Springfield, MA
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RN Case Manager-
Pediatrics/Maternal
Child & ED

Valley Baptist
Health System
Harlingen, TX
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Lead Case Manager (RN)
Memorial Hermann
Healthcare System
Houston, TX
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CMS to Continue PEPPER Reports in January
The Centers for Medicare & Medicaid Services (CMS) recently announced the selection of TMF Health Quality Institute to prepare the Program for Evaluating Payment Patterns Electronic Reports (PEPPER). The reports are used by general acute-care hospitals and long-term care hospitals to identify Medicare severity diagnosis-related groups (MS-DRGs) at high risk for payment errors. Many hospitals use PEPPER data to identify areas for quality improvement and prepare for greater Medicare oversight by auditors such as Recovery Audit Contractors (RAC). Beginning in January, hospitals will receive the reports on a periodic basis from TMF. - read more...

 
Uninsured ED Patients Twice as Likely to Die
According to a recent study published in the Archives of Surgery, uninsured patients who have suffered traumatic injuries are nearly twice as likely to die in the hospital as similarly injured patients with health insurance. The study, performed by Harvard University researchers, examined data from the National Trauma Data Bank from January 1, 2002 through December 31, 2006. Researchers found that uninsured patients, who had experienced traumatic injuries as a result of events such as automobile accidents, falls, and gunshot wounds, were 80% more likely to die than their insured counterparts. - read more...

 
Inpatient Satisfaction on the Rise
According to a recent report from Press Ganey Associates, hospital patient satisfaction levels rose significantly in 2008. To produce the report, Press Ganey surveyed nearly 3 million patients treated at more than 2,000 hospitals nationwide in 2008. According to the report, patient satisfaction within U.S. hospitals has grown steadily since 2003. In 2008, hospitals saw a 1.5% increase in overall inpatient satisfaction, and a 2% increase in willingness to recommend their hospital to family and friends. Researchers found that the patients surveyed rated their overall care between "good" and "very good." - read more...

 
CMS Open Door Forums
 
The Centers for Medicare and Medicaid Services (CMS) offer Open Door Forums (ODFs) as an opportunity for live dialogue between CMS and the provider community. ODFs are held regularly, and address a variety of topics and issues in health care. CMS will be hosting several ODFs during the month of December, which will address a wide range of topics including home health and skilled nursing facilities.

For participation information, and to learn more about the various Open Door Forums that CMS offers, click here.

 
2010 NICM/ACMA National Conference
 
Register Now for Savings
The new NICM/ACMA National Conference website was recently unveiled. If you have not yet done so, we encourage you to visit the website for session information, information on attractions in this year's host city, online registration, and much more. Register early for savings on this year's event – the Early Registration deadline is February 5, 2010. The conference will be held April 8-11, 2010 at the Grand Hyatt San Antonio on the Riverwalk in San Antonio, TX. For more information, visit www.casemanagementconference.com.

 
ACMA Leadership Webinar Series
 
Have You Registered?
If you have not yet done so, we encourage you to register for the remaining webinars in the series. In addition, if you missed any of the previous webinars, you may still register and access them in recorded format. The next webinar in the series – Leadership and Change - Future Changes in Healthcare and the Role of Case Management – will be held January 20, 2010. For dates, details, and online registration visit the Leadership Webinar homepage at www.acmaweb.org/leadership.

 
ACM™ Certification Application Deadline Reminder
 
If you plan to take the ACM™ exam during April, May, or June of 2010, begin making plans now to submit your application. February 15, 2010 is the ACM™ Certification application deadline for the second quarter of 2010. Applications and payment must be received by the ACMA National Office by February 15th in order to take the exam during this time. For more information on the ACM™ Certification, and to download the application, click here.
Upcoming Events

 
Jan. 20, 2010
ACMA Leadership Webinar Series
Leadership and Change - click here
 
Feb. 3, 2009
ACMA Leadership Webinar Series
Optimizing Benchmarking - click here
 
Feb. 17, 2010
ACMA Leadership Webinar Series
Assessment to Resolution - click here
 
Feb. 17, 2010
Southern California Chapter Conference
San Diego, CA - click here
 
Feb. 17, 2010
2010 NICM/ACMA National Conference
San Antonio, TX - click here
 
For more information on ACMA meetings and events visit the online Calendar of Events.
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