Hospital Case Management Advisor - 2017 Article Archive

2017 Articles
by Phoenix Medical Management, Inc.

The articles on this page were published by us throughout 2017. As with all our written work, we welcome your thoughts or critique. Feel free to send an email to


When Will We Get It Right...The First Time?

"Part of the problem is that by doing it right, you are solving tomorrow’s unseen problems today. This results in spending extra time that doesn’t result in any immediate visible progress. Non-technical people place no value in problems they can’t see" [...]

HIPAA Compliant SmartPhone

Mobile devices, including cell phones, tablets, and laptops, are increasingly ubiquitous in many hospitals. They are generally convenient and productive. But with the increased usage of SmartPhones to communicate between case managers and physicians, hospital execs should address the potential risk regarding electronic PHI. [...]

Senior Medicine: When More Isn't Better

A movement to slow down excessive care runs into the culture (and business) of the healthcare industry. This article was written with the support of a journalism fellowship from New America Media, the Gerontological Society of America and the Silver Century Foundation. [...]


Preparing for Care Coordination

In a departure from most graphics depicting a care coordination model, our understanding of a patient-centric approach works best when the patient has a partner to help navigate through the complexity of the health care system. The goal is to engage, educate and empower through [...]


Initial Patient Assessment and LACE

The LACE is a validated risk assessment tool to identify patients who may be at risk for readmission. With staffing shortages that limit the volume of patients who can be managed by a case manager, many hospital case management leaders are relying on the LACE to target patients who would benefit most from focused care coordination. [...]


Care Coordination and Resilience

To be successful in a risk-based population health environment and to fully serve the people who comprise those populations, we need different approaches to delivering health care. CareOregon embeds Master’s prepared Psychology Counselors, Social Workers, and Family Counselors known as "health resilience specialists" into Patient Centered Primary Care Home teams. [...]


Emerging Fourth Generation Hospital Care Management

Fourth generation, patient-centered care management is a value-based model of care that puts patients at the center of clinical decision-making, and respects the patient’s experience, values, needs and preferences in the planning, co-ordination and delivery of care. Central to this model is the relationship between the patient and the care manager who serves as the patient's proactive advocate. [...]


Care Coordination PROMs

"PROMs are precisely the missing link in defining a good outcome. They capture quality-of-life issues that are the very reasons that most patients seek care.” Neil Wagle, MD, MBA, Partners HealthCare, Brigham and Women's Hospital, Boston. [...]


Medics as Transition Coaches

There are hundreds of military combat medics and corpsmen returning from Iraq and Afghanistan who need jobs and who could help preserve the health of patients released from hospitals across America. Wouldn’t it be ideal if they could do what HonorHealth's transition coaches are doing? Originally posted July 1, 2014 but worthy of your attention today. [...]

Hierarchical Condition Categories: What's All The Buzz About?

There is quite a bit of discussion around Hierarchical Condition Categories (HCCs) these days. And for good reason: It is the risk adjustment model used since 2004 to determine reimbursement for commercial Medicare Advantage plans. And now the HCC framework is progressively being applied to numerous healthcare reform initiatives. [...]

Can States Survive The Per Capita Medicaid Caps in the AHCA?

Rationing care to fund high-income tax cuts is not just the byproduct of the Republican Medicaid plan, but rather at the heart of it. The motivation of recently passed bill - to end the guarantee of coverage for those eligible for Medicaid, and replace it with spending caps — seems to be more to do with supply-side fiscal policy than health-care reform. [...]


We Need a Standardized Vocabulary

The traditional "task-oriented" case management program is outdated as the team members have become essential progression of care consultants to the medical staff and leadership. Might be time to standardize terminology to avoid confusing our clients and customers. [...]


Management experience is more important than a nursing license.

While patient care and clinical experience are important skills to advance to a nurse manager, case management director candidates should be able to demonstrate experience in areas such as finance, informatics, and marketing in order to innovate and lead in a time of change and shrinking budgets [...]


Are We Killing Our Young?

The Blind Men and the Elephant is an ancient parable often cited as a warning for people who promote absolute truth. Because our perceptions and life experiences often lead to overreaching misinterpretations, absolute truth is illusive. How can a person with limited knowledge turn that into the one and only version of all reality? [...]

care coordination

Healthcare's dirty 'little secret': No one is officially coordinating care in the hospital

Poor care coordination creates negative consequences for both patients and healthcare providers but it remains an illusive goal in many hospitals.Perhaps because it is often confused with transitions of care.To optimize care coordination,it's vital that execs look at it as a longitudinal process of advocating,influencing,facilitating,and promoting safe,efficient,effective,and timely care throughou [...]


Preferred Post Acute Providers

Hospitals are picking their preferred post-acute care providers which play such an essential role in ensuring that patients receive the care they need to heal and have a smooth transition back to a community-based setting, typically after a discharge from a hospital. [...]


Where is Hospital Case Management

Hospital case manager failure in one hospital affects us all. With the shift to value based care management, its time to examine your hospital program and objectively see if it reflects professional standards of practice and meets new marketplace expectations. [...]


Advocacy and Excessive Blood Draws

Excessive phlebotomy has consistently been implicated as one of the major causative factors in developing hospital acquired anemia and increased risk of morbidity and mortality. If nurses and care managers are aware of this evidence, should their shared advocacy obligation be exercised on behalf of their patient? [...]


Emphasis back on Volume

Last year, U.S. News & World Report expanded it's Best Hospitals for Common Care report and found that patients who receive 5 common surgical procedures and medical conditions at low-volume hospitals have a much higher risk of death or complications, while patients at higher-volume facilities have a reduced risk. [...]


Transitional Care

Transitional care is a range of time limited services that complement primary care and are designed to ensure health care continuity and avoid preventable poor outcomes among at risk populations as they move from one level of care to another, among multiple providers and across settings [...]


After You Say Hello

When it comes to helping patients understand the concept of care management, a couple of good words at the first visit may go a long way to reduce patients concerns and confusion. [...]


The Discipline of Value Based Case Management

Case management directors and their executive sponsors have the opportunity to rethink and challenge their own assumptions and the practical implications of a new way of thinking about hospital case management programs. That means they must both bring a different set of "what-ifs" to the table and a multidimensional view of the current marketplace, new performance expectations, & desired outcomes. [...]

James-Salwitz-MD-Oncologist-Regional-Cancer-Care-Associates-RWJ University Hospital

The enemy is not death. The enemy is needless suffering.

Among hospice staff, it is called “getting it.” One says, “He doesn’t get it,” “I think she gets it,” or, “They definitely get it.” It is a little hard to define, but as with pornography, you know it when you see it. [...]