Instead of paying for hospital and physician services separately, the ACE demonstration program bundles payments for specific cardiac and orthopedic procedures into one lump sum to encourage collaboration.
The case manager must examine every component of the discharge process for opportunities for improvement; one aspect that deserves increased investigation is the handoff of the patient from the hospital to another care provider.
At this juncture in the evolution of case management services, we have reached the tipping point of hospitals acknowledging that they should have some evaluation of each patient’s level-of-care needs at the front door.
When executing an interstate transfer, case managers must account for different Medicaid programs and payers, high transportation costs, and unfamiliar physicians—not to mention the challenge of finding an accepting facility.
