Case Management Department Revamped in Response to Shift in Reimbursement.

Abstract

As DCH Health System in Tuscaloosa, AL, began to assume more risk for patients after discharge, the leadership redesigned the case management department to meet the new challenges. A masters-prepared RN assumed the role of patient navigator and follows total joint replacement patients for 90 days after discharge. The case management staff narrowed down the post-acute providers with which it contracts, based on quality data and cost of care, and requires providers to submit quality data regularly. The multidisciplinary staff holds rounds every day. In addition, there are long-stay rounds twice a week, and daily rounds in the ICU.