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The case manager's handbook / Catherine M. Mullahy

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Intro bio of a case manager. The case manager as catalyst, problem solver, educator -- The case manager's universe -- Case management process: the microsystem level. The case management work format and process -- Communication and patient engagement -- Practice settings and models of care. Hospital case management: changing roles and transitions of care -- ACOs, PCMHs, and state health exchanges -- The growing need for direct-to-consumer, community-based case managers: our changing times -- Care at home -- Managing a long-term case -- Integrated care management: preadmission, concurrent review, utilization review, disease management, and case management -- The case management professional. Legal responsibilities of the case management professional -- Ethical responsibilities of the case management professional -- Evidence-based practice for case managers: data-driven decision making -- Case manager credentialing -- Reimbursement. Reimbursement resources and challenges -- Healthcare reimbursement: private or employer sector funding -- Healthcare reimbursement: public sector -- Working effectively with claims departments: case managers in consulting roles -- Leadership and management: macrosystems. Outcomes management with analysis of financial and quality assurance reporting -- Managing a case management department: your role as case management administrator -- Predictive modeling and case stratification -- Focus on current challenges and emerging trends. The aging population, medical advancements, and new case management considerations -- Dying in America -- Medications: polypharmacy and adherence -- Pain management -- Our nation's multiculturalism and challenges to case managers -- Health literacy and adherence issues -- Obesity: the new epidemic -- Behavioral health -- Healthcare technology and trends: implications for case managers -- The Affordable Care Act of 2010: implications for case managers

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