Reducing unnecessary medicare admissions: A six-state project

Professional Case Management

Volumn 14, Issue 3, 2009, Pages 143-150

  Romero, Andrea ^a   Brown, Carlene ^b   Richards, Ferdinand ^c   Collier, Patricia ^d   Jentz, Susan ^e   Michelman, Mark ^e   Davison, Karen ^e  

^a NMMRA Hospital Payment Monitoring Program (HPMP)   (United States)

^b NMMRA   (United States)

^c FMQAI   (United States)

^d FMQAI   (United States)

^e FMQAI   (United States)

Author keywords

Case management; Case management assignment protocol; Case management protocol; Observation status

Indexed keywords

ARTICLE; CASE MANAGEMENT; COMPARATIVE STUDY; HEALTH CARE QUALITY; HOSPITALIZATION; HUMAN; INSURANCE; LENGTH OF STAY; MEDICARE; NURSING CARE; PROGRAM DEVELOPMENT; PROSPECTIVE PAYMENT; REIMBURSEMENT; STATISTICS; UNITED STATES; UNNECESSARY PROCEDURE;

CASE MANAGEMENT; HOSPITALIZATION; HUMANS; INSURANCE CLAIM REPORTING; INSURANCE CLAIM REVIEW; LENGTH OF STAY; MEDICARE; NURSING CARE; PROGRAM DEVELOPMENT; PROGRAM EVALUATION; PROSPECTIVE PAYMENT SYSTEM; REIMBURSEMENT MECHANISMS; UNITED STATES; UNNECESSARY PROCEDURES;

EID: 68249136892     PISSN: 15297764     EISSN: 15390675     Source Type: Journal    
DOI: 10.1097/NCM.0b013e3181a340c4     Document Type: Article

References (6)

1. Centers for Medicare & Medicaid Services. (2006, January 10). First-look Analysis Tool for Hospital Outlier Monitoring (Version 13.0; FY 2002-FY 2005). Austin, TX: TMF Health Quality Institute, Hospital Payment Monitoring Program QIO Support Center. [QIO access only.]
2. Centers for Medicare & Medicaid Services. (2008, June). The Medicare Recovery Audit Contractor (RAC) program: An evaluation of the 3-year demonstration. Baltimore, MD: U.S. Department of Health and Human Services. Retrieved November 17, 2008, from http://www.cms.hhs.gov/RAC/Downloads/ RAC%20Evaluation%20Report.pdf
3. Michelman, M., Collier, P., Dion, C., Richards, F., Ohleyer, H., Vasey, P., et al. (2005). A case management protocol: Reducing unnecessary Medicare admissions in Florida. Lippincott's Case Management, 10(2), 72-80.
4. New Mexico Medical Review Association. (FY 2005). Analysis of data from the New Mexico Payment Error Cause Analysis. Austin, TX: TMF Health Quality Institute, Hospital Payment Monitoring Program QIO Support Center. [QIO access only.]
5. Office of Management and Budget. (2008, January 31). Improving the accuracy and integrity of federal payments. Washington, DC: Executive Office of the President. Retrieved November 17, 2008, from http://www.whitehouse.gov/ omb/financial/fia/2007-ipia-final.pdf
6. Richards, F., Pitluk, H., Collier, P., Powell, S., Dion, C., Struchen-Shellhorn, W., et al. (2008). Reducing unnecessary Medicare hospital admissions for chest pain in Arizona and Florida. Professional Case Management, 13(2), 74-84.