How to Succeed in the Changing Healthcare Marketplace.

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Abstract

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.

如何在不断变化的医疗保健市场中取得成功。
随着CMS和商业支付方转向基于质量的报销,医院领导层和员工需要寻找提供医疗服务的新方法,以便在快速变化的医疗保健市场中取得成功。专家预测,即使国会废除《平价医疗法案》(Affordable Care Act),按绩效支付薪酬的举措也将继续存在。由于医院在出院后长达90天内对患者的预后承担风险,病例管理人员必须识别有风险的患者,并从长期的角度考虑他们的护理。病例管理领导需要收集和报告医院在质量度量方面的表现数据,然后开发和执行流程改进项目。病例管理人员应重新评估他们与急性后提供者的关系,并跟踪质量指标和成本,以确保他们提供有效的护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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