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On our radar: Case management

CMS extends MAPCP demonstration for six states

Six of the eight states that are currently participating in the Centers for Medicare & Medicaid Services’ Multi-Payer Advanced Primary Care Practice demonstration model — Maine, Michigan, New York, North Carolina, Rhode Island and Vermont — have been offered an extension through 2016. CMS has offered to extend the demonstration in states for which some of the MAPCP demonstration payment goes to community-based organizations that could not bill independently under the Chronic Care Management codes proposed to take effect in January 2015.

The eight states, including Pennsylvania and Minnesota, were selected to participate in the ongoing model that began in 2010.

The demonstration program pays a monthly care management fee for beneficiaries receiving primary care from advanced primary care practices. The care management fee is intended to cover care coordination, improved access, patient education and other services to support chronically ill patients.

Each project, conducted and coordinated by the participating state, includes Medicaid and substantial participation by private health insurers, shows support by the primary care providers and is coordinated with state health promotion and disease prevention efforts.

Additionally, each participating state has mechanisms to offer APC practices community support and linkages to State health promotion and disease prevention initiatives.

Medicare participation started July 11, 2011, in Vermont, New York, and Rhode Island. North Carolina and Michigan began participation Oct. 1, 2011, and Maine, Minnesota, and Pennsylvania became operational Jan. 1, 2012. At the start of 2015, each state’s program will have been operational for at least three years, with an expected participation of about 1,200 medical homes serving more than 900,000 Medicare beneficiaries.

CMS participates in multipayer reform initiatives that are being conducted by states to make advanced primary care practices more broadly available. The demonstration evaluates whether advanced primary care practice will reduce unjustified utilization and expenditures; improve the safety, effectiveness, timeliness and efficiency of healthcare; increase patient decision-making; and increase the availability and delivery of care in underserved areas.

To view an interactive map of this model, visit the Where Innovation is Happening page at www.CMS.gov.

Case Management Society of America takes to Capitol Hill

The Case Management Society of America, its national board and public policy committee and about 60 case manager CMSA members came together on Capitol Hill in Washington, D.C., on Sept. 10 to address the value that professional certified case managers bring to improving care coordination and transitions of care with patients and their family caregivers.

“We are committed to ensuring that members of Congress know who we are and the value we bring, not only in D.C. but also at the state level where our case managers practice,” Patricia Noonan, MBA, RN, CCM, chairwoman of CMSA’s Public Policy Committee, said in a press release. “Each year it is exciting to see the passion and commitment case managers bring as they share their stories.” During the visit, case managers met with their representatives from the House and Senate concerning their advocacy for legislative issues such as increased use of qualified professional case managers; safer transitions of care for patients, advanced training and competency for case management professionals; and aligned financial and performance measures in support of the collaborative practice of case management.

The society’s leadership had the opportunity to engage with members of the Health Resources and Services Administration) and policy directors at the Executive Office of the President, Office of Management and Budget, to share the same message.

“Our continued presence in D.C. encourages the development of provisions supporting case management, care management and care coordination, while continuing to demonstrate the value of case management by clarifying the significance of case managers in improving care coordination workflow and processes,” Kathleen Fraser, MSN, MHA, RN-BC, CCM, CCRN, CMSA president, said in the release. “Bringing this message to Washington and safeguarding the practice of case management is the most important role we can take to support our members,”

CMSA’s virtual community also participated via Hill Day-related updates on Twitter, Facebook and LinkedIn, garnering more than 2,700 views and initiating more than 150 actions including shares and retweets. The CMSA invites encourages case managers to participate year-round by sending letters and sharing stories of how professional case managers improve care for their patients and family caregivers to state representatives.

For more information visit, www.cmsa.org/policymakers.

National Case Management Week provides time for celebration, recognition

During National Case Management Week, Oct. 12-18, the Case Management Society of America recognized the vital involvement of case managers in the healthcare community.

National Case Management week provides a time for CMSA, its members and other organizations to honor, celebrate and increase appreciation for what case managers contribute to the healthcare community.

The national association collaborates on a number of initiatives that include the National Transitions of Care Coalition, the Hospital Care Collaborative, the National Quality Forum advisory panels and others.

CMSA’s 2014 theme for National Case Management Week was “Building Steps to a Brighter Future.”

The association is committed to promoting the growth and value of case management with its international reach of more than 25,000 members and subscribers through a network of m

By | 2014-11-21T00:00:00-05:00 November 21st, 2014|Categories: National|0 Comments

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