Hospital Case Management Utilization Management: At the Bedside or Centralized? Recorded Webinar | Bev Cunningham | From: Feb 04, 2021 - To: Dec 31, 2021 |
As hospital case management departments have evolved and matured, leaders are required to evaluate models and roles. Typically, all four roles of utilization management, care coordination, discharge planning, and resource management have functioned at the bedside. With the challenge of the lack of candidates to fill all positions, as well as the challenge of payers and rules, requirements, and regulations, hospital case management leaders are evaluating the appropriate place for utilization management to reside.
There are challenges and advantages of each location for utilization management. As these decisions for hospital case management leaders have arisen, another entrance in the hospital case management realm has come into being—Artificial Intelligence.
As these critical decisions are being made, leaders must determine the appropriate location for utilization management in their facility, as well as the best method for performing utilization management. This requires strategy, planning, appropriate roles, collaboration, and optimal outcomes. These will all be discussed in the webinar.
Learning Objectives:-
Why should you Attend?
With the focus on accuracy and efficiency in hospital case management, all four case management roles are being examined. These roles include utilization management, care coordination, discharge planning, and resource management. The role that has the most intense scrutiny is that of utilization management. This role can be quite challenging as payers, especially managers of Medicare and managed Medicaid payers have varying rules and regulations. These rules and regulations can change frequently.
As case management departments are challenged with ensuring all roles are filled and that all staff is working at the top of their license, both efficiently and compliantly, hospital case management leaders are evaluating the place where utilization management should reside—at the bedside……..or centralized?
This webinar will review both models of utilization management and give the attendee understanding of the pros and cons of each mode
Who should Attend?
Bev Cunningham, MS, RN, ACM is a founding partner of Case Management Concepts, LLC. She has a 25-year deep working knowledge of case management with specific expertise in denials management, patient flow and the role of the Case Manager and Social Worker in the Case Management process. Bev is also a certified case manager with the American Case Management Association. She has served as a Commissioner on the Commission for Case Management Certification and is a fellow with the Advisory Board. Bev is also the former Vice President of Resource Management at Medical City Dallas Hospital.
She has co-authored a book for hospital case managers—Core Skills for Hospital Case Managers and has written the utilization management chapter in the past two editions of CMSA’s book, Core Curriculum for Case management.
