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Case Management Exhibitor Information
What Exhibitors Should Know About CMSA
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Case Management Definition
CASE MANAGEMENT is a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes.
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Primary Work Settings
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Question: What Tasks Are Currently Included in Your Job Duties?
One Job – Many Duties Question: What Tasks Are Currently Included in Your Job Duties? Pre-certification Benefit Determination Risk Management Medical Legal Consultation Life Care Planning Disease Management Utilization Management Case Management Discharge Planning Health & Wellness Coaching Research IT or Data Services Direct Patient Care/Education Product Development Disability Management Negotiation – contracts & fee schedules Telephonic/On-site Case Management Medication Therapy Management Education – patient, provider, & staff Accreditation Telephonic Demand Management Source: CMSA 2007 State of the Industry Survey
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Industry Issues Health Care Reform Care Coordination
Transitions of Care Patient Safety Medication Reconciliation Payment Alignment & Performance Measures New Models of Care Patient & Family Caregiver Engagement Collaborative Practice
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Transition Issues Dramatically Impact Patient Care
Continuum Case Mgrs OUTPATIENT: Home PCP Specialty Pharmacy Case Mgr. Care Giver Patient ER ICU ED Case Mgr In-Patient SNF ALF Hospital Case Mgr Patient Managed Care Case Mgr
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We Serve Many People Along the Health Care Continuum
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One Job – Many Names MY JOB TITLE IS: Case Manager Care Manager
Care Coordinator Discharge Planner Disease Manager Department Supervisor Department Manager Department Director Utilization Manager Other Social Worker Senior Care/Rehab Occupational Nurse Source: CMSA 2007 State of the Industry Survey
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CMSA Standards of Practice:
Evolution of the SOP Definition of CM CM Practice Settings CM Roles, Functions, Activities Components of the CM Process Standards of Practice Glossary and Acronyms References Currently under revision
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Today’s Case Manager Today, case managers are in most elements of the payer and provider communities where the need to balance quality care and cost-effective care exists. The process of case management begins with identification of high-cost, complex care individuals who meet criteria for and can benefit from case management services Source: CMSA Standards of Practice
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Healthcare Reform – On The Horizon
Baucus Call to Action – Strengthening the role of Primary Care and Chronic Care Management H.R – Supports the Transitional Care Model The Senate Health, Education, Labor and Pensions (HELP) Committee released a “draft of a draft” of healthcare reform legislation. Group and individual health insurers must implement a reimbursement structure that provides incentives for: The implementation of case management, care coordination, and chronic disease management activities for treatment or services under the plan;
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Collaborative Care, Care Coordination and Transitions of Care Models
Dr. Eric Coleman – Transition Coaching Dr. Mary Naylor – Transitional Care Model Dr. Chad Boult – Guided Care Nurses Medical Home Demonstration National Transitions of Care Coalition (NTOCC) American Geriatric Society National Coalition on Care Coordination (N3C)
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Developing Care Coordination Measures
CMS 9th SOW supports Care Coordination Care Pathways 2009 TJC Patient Safety Standard #8 enhanced Medication Reconciliation to include patient and caregiver involvement and transition Documentation of process NQF developing Performance Measures for Care Coordination Call for Best Practices December 2008 Measures Development in 2009 URAC incorporating TOC principals in revised CM Standards AMA – PCPI Transitions of Care ACP/SHM/ABIM Foundation/PCPI will develop jointly practitioner-level performance measures for transitions of care
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Clinical & Administrative Transactions
The Continuum of Care Clinical & Administrative Transactions Pharmacy Employer Physician Office Specialist Case Manager Hospital Community Health Center PBM Patient Adherence Assessment & Support Health Promotion Motivational Advocacy Prescription Assessment & Care Plan Motivational Interventions Advocate Assessment Medication Reconciliation Care Plan Coordination Non-Adherence Behavior Health Change Facilitation Increase Productivity “Rubik’s cube” at work, with high volume of often disaggregated transactions Physician-centric view of today's flows - important that 80% of spending is driven by the decisions at the hub of these transaction flows Two key types of transactions: clinical (e.g., ordering a lab and getting those results) and administrative (e.g., scheduling a patient visit). Again, bigger opportunity is in clinical.
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Case Management Society of America
CONNECTING YOU TO CASE MANAGERS
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Expanding Our Reach Currently approaching 12,000 members
Additional 15,000 subscribers Over 200 company members 75 geographic chapters Presence across the continuum 34% in managed care/insurance 26% in acute care/hospital setting 12% in work comp/occupational health/employers 9% in government agencies/military
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Reaching Case Managers Year-Round
Educational opportunities and events In-person and on-line With or without continuing education credits Tools and resources Increasing knowledge and case management effectiveness
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Educational Research Library
INCLUDED IN MEMBERSHIP CMSA’s online educational resource offers programs to care managers and allied health professionals serving the care management industry. COURSEWORK LEVELS Basic Intermediate Advanced FREE CE and Non-CE Courses (CM/DM/UM) My Coursework Masters Level Coursework Other Resources Business Courses
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Case Management Adherence Guidelines
Adherence Assessment Motivational Interviewing Follow-up Using: Accessible Material Focused Learning Tools and Resources
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Growth of CMAG Currently in second revision
In 2006, launched first disease specific supplement: Diabetes DVT Depression Cardio metabolic risk COPD (in development) Translated into three languages
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Resource Paths Guides used by case managers to help navigate assessment, treatment and intervention Designed to be mentoring and “as needed” training devices Can incorporate new clinical, assessment and intervention methods Advocate to the health care team
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Corporate Partnership
Access to attendee and membership lists Discounts for exhibit booths and other CMSA products Complimentary individual memberships and conference registrations Heightened visibility
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2010 Annual Conference & Expo
CMSA’S 20th ANNIVERSARY June 8 – 11, 2010 Walt Disney World Coronado Springs Resort Orlando, Florida
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New Outreach Opportunities
Educational and Promotional Events CE Symposia Non-CE Symposia General Conference Sponsorships 12 months of promotion Website Print material E-communications Signage and recognition
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Partnering With Disney
Coast-to-Coast Party Kick-Off Event Exclusive use of Disney’s Hollywood Studios Unique branding and promotion opportunities Exclusive and wide-spread promotion of sponsors Disney’s Exhibitor Concierge Service Theme Park Events & Tickets Entertainers Cutting edge AV and booth presentations
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Conference Opportunities
EXHIBIT BOOTHS: contact the Exhibit Management Team for more information SPONSORSHIPS: available for all budgets and guidelines STRATEGIC PACKAGES
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Key Contacts MICHELLE KOCH Director, Corporate Accounts LINDSAY HARP Account Representative J. MICHAEL HOEHN Vice-President, Business Development HARRY ALBA Corporate Accounts SYLVIA JOHNSON Conference Coordinator SHELLY GREENWOOD Event Planner
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Thank You for Your Support of Case Management
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