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CareManagement is a trusted and valued resource for case managers seeking information on the latest topics impacting case management practice today. 

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Inside this Issue

Vol. 28, No. 3, June/July 2022

Case Management: A Look Back, A Plan Forward CEU   

Laura Ostrowsky, RN, CCM, MUP

Health care has changed in many ways over the past 50 years. Costs have risen, length of hospital stay has dropped, and levels of care have multiplied. In 1985 Medicare changed the payment methodology from per diem to diagnosis-related groups, a period which could be considered the “dawn” of case management. A major milestone was reached in 1990 when the Case Management Society of America (CMSA) was founded. Case management started out as a review of medical necessity but has blossomed into an essential part of health care delivery and planning.

HIPAA (Part 1): What Is It and Why Should I Care? CEU   

Kathleen Fraser, RN-BC, MSN, MHA, CCM, CRRN, FAAN

HIPAA was signed into law in 1996 by President Bill Clinton. It was first proposed with the simple objective to ensure health insurance coverage after changing or leaving a job. The privacy rule protects the privacy of a person’s health information and keeps it from being misused. HIPAA gives people the right to receive and review their health records and to choose with whom their health care providers and health insurance companies share their information (including friends, family members, and caregivers). The law also includes standards for setting up and maintaining secure electronic health records.

The Post-COVID Pathway to Resilience in Case ManagersCEU 

Rajitha Bommakanti, RN, CCM

During the pandemic, the inadequate resources, overloaded caseloads, and the intensive care units at maximum capacity put an extra burden on healthcare workers. As case complexity increased, the experiences of moral distress heightened among healthcare workers. In order to lower inflammation in the body and for the body to heal and rejuvenate at the cellular level, evidence-based polyvagal theory tools can be incorporated. Seven simple techniques can be used to increase the tone of the vagus nerve to calm the nervous system and lower stress. These include mindful breathing; singing, humming, and gargling; meditation; exercise; social engagement; and compassion; and laughing.

Special Sections

Announcing...

CareManagement is the journal of the Commission for Case Manager Certification, the Academy of Certified Case Managers, a journal of the Case Management Society of America.

PharmaFacts for Case Managers

Approvals, warnings and the latest information on clinical trials—timely drug information case managers can use.

LitScan for Case Managers

The latest in medical literature and report abstracts for case managers.

Departments:

From the Editor-in-Chief

Becoming Patient Centric

From the Executive Editor

Celebrations and Reflections

Legal Update I

Why Every Provider Must Establish and Maintain a Fraud and Abuse Compliance

Legal Update II

Nurses!

News from CMSA

Greetings from the New President of CMSA

News from CARF

Greetings from the New President of CMSA

News from CCMC/CDMS

“You’ve Got This”: The Message to CCM & CDMS Exam Candidates —and All of Us

News from the VA

Journey of Care Coordination and Integrated Case Management in the Veterans Health Administration

Case Manager Insights

Meeting Clients Where They Are, Even When They are Far Away

 

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