2004 – A Comparison of 4 Hospitals Strategic Initiatives Leading to Successful Ratings for 2 Midnight Short Term Audits.
This lecture will compare and contrast strategic initiatives used by 4 hospitals and their case management departments which led to successful scores and ratings for 2 Midnight Short Term Audits. Exploring each of these hospital’s perspective will prove critical in 2020, as Medicare transitions the Short Term Audits from the QIO’s to the RAC. Participants will be provided with multiple initiatives and program options, that will be examined thru group discussions and comparisons to their own work experiences. Through this process, participants can determine which strategic initiatives may prove to be a fit for their department and organization. To facilitate this process, the different strategic approaches will be outlined on a easy to use resource, that will allow participants to refer to during and after the lecture.
Among the strategic elements to be compared are case management models, physician education approaches to 2 Midnight Rule, use of the Physician Advisor, Physician Documentation training methods, Social Work supportive measures, proactive preparation of the medical record, awareness of auditors review processes and advantage of working more closely with Auditors. Open classroom discussions will expand the participant’s lecture experience.
In summary, the content of this lecture, is current and relevant to a case manager’s practice and the presentation format promotes direct application to their utilization management practices.
1. Compare and contrast the strategies presented in this lecture to those currently used in your own department, while identifying those that may be an option for practice improvement
2. Describe how the material presented can be used to expand your understanding of the 2 midnight rule and improve your utilization review outcomes
3. Assess using critical thinking: create one program option not mentioned, that might prove beneficial for your case management department