How to Succeed in the Changing Healthcare Marketplace.

Hospital leadership and staff need to look at new ways of delivering care to succeed in the rapidly changing healthcare marketplace as CMS and commercial payers move toward basing reimbursement on quality. Pay-for-performance initiatives are here to stay even if Congress repeals the Affordable Care Act, experts predict. As hospitals assume risk for patient outcomes for as long as 90 days after discharge, case managers have to identify at-risk patients and think about their care on a long-term basis. Case management leadership needs to collect and report data on the hospital's performance on quality measures, then develop and carry out process improvement projects. Case managers should reassess their relationships with post-acute providers, and track quality metrics and costs to ensure they are providing efficient care.