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Recent Articles

  • UR and Medical Necessity

    This article was recently posted by Glenn Kraus on HCPRO's CASE MANGEMENT WEEKLY. With his permission, it is essential reading for HCM leaders. It highlights the reasons why the UR function can no longer be an 'add on' activity to the hospital case managers' role.  Executives lax attention to the issues surrounding 'medical necessity' is no longer realistic if the hospital wants to financially thrive.
  • Laying the Foundation

    Designing and executing a clinical resource management program is not easy.  It’s not so much that any one part of the program is difficult to design and implement.  Rather, it’s the combination of all the parts that becomes untenable.

     
  • What gets Measured gets managed!

    When we started this newsletter back in 1994, we reported the difficulties in obtaining information about payer denials.  Hospitals simply could not provide actionable information to identify the source of their denials...
  • The Business Case for Hospital Case Management

    When case management was introduced in hospitals in the mid 80s, it was accompanied by a promise to control costs at the bedside.

Resources

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The Leader's Guide to Hospital Case Management
The first textbook devoted exclusively to the specialized needs of hospital case management programs! Co-authored by the partners of Phoenix Medical Management.
Follow this link to find out more and order your copy today.

 

 

 CRM UPDATE

Follow this link for the latest issue of CRM UPDATE, our monthly newsletter with up to date information and practical insights on the continuing evolution of hospital case management practice. CRM UPDATE, our free newsletter is written specifically for hospital case managers.  

ARTICLES

Daniels, S. and Frater, J. "Hospital Case Management and Progression-of-Care." HFM, August 2011, p 108-113

Daniels, S.  "Introducing HCM v.3.0." Lippincott's Professionasl Case Management, May-June, 2011, 16(3):109-125 http://journals.lww.com/professionalcasemanagementjournal/Fulltext/2011/05000/Introducing_HCM_v3_0__A_Standard_Model_for.4.aspx

Daniels, S. and Gordon Taft, R.  "Allow Natural Death."  Case in Point, June-July, 2010 digital edition p. 52-54  http://accessintelligence.imirus.com/Mpowered/imirus.jsp?volume=cip10&issue=4&page=1

Daniels, S.  “Advocacy and the Hospital Case Manager.”  Lippincott’s Professional Case Management journal. Jan-Feb, 2009, Vol. 14/No. 1, pp 48-51.

“Make Advocacy and quality the focus of a comprehensive case management program.”  Interview with Stefani Daniels. Case Management Monthly,  HCPro, Vol. 5, No. 11, Nov 2008.

Daniels, S. and Ramey, M.  “Faster than a speeding bullet: Changes in Medicare rules for the hospital case manager.”  Lippincott’s Professional Case Management journal. Vol 13(5) September/October 2008, p253-261

Daniels, S.  “The Myth of Length of Stay.”  Web publication. HealthLeaders Media. July 14, 2008.    http://www.healthleadersmedia.com/content/215087/topic/WS_HLM2_FIN/The-Myth-of-Length-of-Stay.html

Daniels S and Reece R. “The Business Case for Hospital Case Management.” Web publication: Media HealthLeaders. March 2, 2007.  http://www.healthleadersmedia.com/content/87605/topic/WS_HLM2_HOM/The-Business-Case-for-Hospital-Case-Management.html

“One-on-One Relationships with Case Managers Help Financially, Qualitatively.” Interview with Stefani Daniels. Hospitalists and Inpatient Management, Vol 7, No 3, March, 2005.

“Hospitalists and Case Managers - The perfect partnership.” Ramey M and Daniels S. Lippincott’s Case Management journal, Nov-Dec 2004, Vol. 9, No. 6. pp 280-288.

“Working with Physicians Benefits Patients’ Care.” Interview with Stefani Daniels. Hospital Case Management, April 1, 2004, American Health Consultants.

S. Daniels. "Designing a Hospital Case Management Program."
Lippincott's Case Management, March-April 2003, Vol. 8, No.2, pp 83-87.

J. Henson & S. Daniels. "Don't Squander Case Management Resources."
Lippincott's Case Management, March-April 2002, Vol. 7, No. 2, pp 59-60.

"Practical strategies to develop a customer-centric hospital case management model"
in Hospital Case Management, October, 2001

M. Ramey & S. Daniels. "Hospital case managers: Diamonds in the Rough."
Lippincott's Case Management, Sept-Oct 2001, Vol. 6, No. 5, pp 205 - 207

S. Daniels. "Addressing the limits of hospital-based case management."
Care Management, October, 2000, pp 16 – 20

M. Ramey & S.Daniels. "Case Managers in the Hospital Workplace – A Lighthearted View at Century's End."
The Case Manager, Jan-Feb 2000, pp 55 – 58

S. Daniels & M. Feigenbaum. "Physician gainsharing deserves a chance."
The Joint Commission Journal of Quality Improvement, Dec. 1999, pp 651 – 653

S. Daniels. "Danbury Hospital updates its Case Management Program."
Inside Case Management, 11/99 pp 5 – 8

S.Daniels & M.Feigenbaum. "Physician gainsharing deserves a chance."
Florida Medical Business, August 24, 1999, Vol 12, No. 17

S. Daniels. "Using hospital based case management to reduce payer denials"
HFMA 5/99 pp 36-39

S. Daniels. "CM program helps make hospital profitable."
Hospital Case Management, 9/98 pp 174 – 177

S. Daniels & J Sands. "Case Management: A formula for resource conservation."
Journal of Healthcare Quality Jan/Feb, 1996 pp 9 - 13



REFLECTIONS

Welcome to the February issue of REFLECTIONS, the new name for our monthly e-newsletter. The lead article is about 'leveling the playing field' between the hospital and its medical staff with the Federal prepayment processes adopted by the MACs and the RAC demonstration project.  We also feature a research stufy on meds that are responsible for ED visits and emergency rehospitalizations which supports our contention that the clinical pharmacist must take an active role in preparing patients and families for transition from the hospital.  As always, we welcome your comments and thoughts. 

CMSA's Core Curriculum 2nd Edition

Suzanne K. Powell and Hussein Tahan have put together a text containing the core body of knowledge for case management practice as delineated by the Case Management Society of AmCMSA-Core-book.jpgerica (CMSA), the largest professional organization of case managers. This edition is significantly expanded to reflect the dynamic changes taking place in case management. Each chapter is organized in a consistent format that includes learning objectives; introduction; important terms and concepts; key definitions; and references.