ACMA Case Management Certifican study help
When does care coordination begin and end
Prior to admission for elective procedure - 30-90 days after discharge.
Pay for performance models have a greater emphasis on
Value based purchasing, readmission, Hospital acquired conditions
What factors ef...
ACMA Case Management Certifican
study help
When does care coordination begin and end
Prior to admission for elective procedure - 30-90 days after discharge.
Pay for performance models have a greater emphasis on
Value based purchasing, readmission, Hospital acquired conditions
What factors effect value based purchasing?
quality of care,, reduce adverse events/safety, improving patient experience,
efficiency/delivering low cost care.
What does the Acronym LACE stand for in the Lace Assesment tool..
LENGTH of Stay, ACUITY of Admission, COMORBIDITY, EMERGENCY Deoartment
Visits.
What are the 8 ps in The Society for Hospital Medicines Project Boost Risk
Assesment - Readmission Assement
Problems with Medications, Psychological,
Principal Diagnosis,
Physical Limitations,
Poor Health Literacy,
Patient Support,
Prior Hospitalization,
Palliative Care
Components of RED ( Reengineered discharge)
Asses need for translator,
sched f/u appointments,
f/u on outstanding test results,
coordinate post d/c out-patient services,
obtaining medications
national d/c guidelines,
d/c teaching,
educate on what to do if problems arise,
assess pt understanding,
d/c summary to outside providers, d/c follow up call.
After Hospital Care Plan (AHCP)
In regards to Value Based Pricing/payments, What factors weigh heavily in
clinical care outcomes?
mortality
In regards to Value Based Pricing/payments, what factors are considered in
Patient experience of Care
staff communication,
receiving written d/c information, warning signs,
explanation of medications,
pain management,
overall experience.
, In regards to Value Based Pricing/payments, what factors are used to determine
payout based on efficiency.
spending per beneficiary, 3 days prior to admission to 30 days post d/c.
Resource utilization,
length of stay,
post acute services.
In regards to Value Based Pricing/payments, what factors are used to determine
payout for safety?
Various patient safety factors and infection rates
What is the definition of health literacy ?
the degree to which individuals have the capacity to obtain, process and understand
basic health information and services needed to make appropriate health decisions.
What are social determinants of health?
The structural determinants and conditions in which people are born, grow, live, work,
and age which have a significant impact on health outcomes.
What are the components of a psychosocial history
family composition, education, occupation, psychological and/or psychiatric functioning,
living siuation, support system, transportation concerns, life changes or stressor, cooing
skills, social/ community involvement, spiritual aspects and concerns, self care,
cognitive or perception problems, financial concerns.
What is the required assessment for admission to a nursing home for a patient
with a diagnosis of mental retardation or mental illness to assure appropriate
placement
Federal Pre-Admission Screening and Resident Review. Some states may require
additional screening tools.
What factors effect social determinents of health?
economic stability, neighborhood and built environment, education, food, community
and social context, health and health care.
Required assessment for admission to a nursing home for a patient with a
diagnosis of mental retardation
Federal Pre-Admission Screening and Resident Review. Some states may require
additional screen in ng tools.
What is utilization and review?
reviewing patients clinical condition and providing decis I on support to MD on bed and
billing status. ie observation, Out Pt, In-Patient. and being prepared to justify medical
necessity. Additional certification is required for admission Ions longer than 20 days.
components of the psychosocial history
family composition, education, occupation, psychological and/or psychiatric functioning,
living siuation, support system, transportation concerns, life changes or stressor, cooing
skills, social/ community involvement, spiritual aspects and concerns, self care,
cognitive or perception problems, financial concerns.
Physician certification or recertification for admissions longer than ____ days
requires what documentation?
20 days.
Reason for hoslitalization estimated length of continued stay, post acute plans,
if patient is only waiting on SNF placement must indicate reason for delay.
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