HCQM - Case ManagementHi: Questions With Solutions
Liberty Mutual used case management to help with this population's cost
management in the 1940's. Right Ans - Workers' Compensation
Early public health case management efforts focused on these two areas.
Right Ans - Psychiatry and social work.
Following this event many insurance companies employed nurses and
social workers to take care of patients with multiple and complex injuries.
Right Ans - World War II
Intracorp Right Ans - Founded by CIGNA in 1966 for workers'
compensation; included both vocational rehab and nursing care
management; aimed at cost management
Health Maintenance Organization Act of 1973 Right Ans - Removed
restrictions and provided grants and loans to develop HMO alternatives to
traditional health care
The Older Act of 1978 Right Ans - Resulted in case management of
elders throughout the US
Case management and utilization review for medical necessity were
adopted into general insurance pools in this decade Right Ans - 1980's
Case Management Right Ans - A cost containment tool for managing
complex and catastrophically ill and injured patients. It is considered an
advanced practice of various healthcare professions.
Case Management Society of America Right Ans - Founded in 1995.
Published the first Standards of Practice for Case Management.
Standards of Practice for Case Management Right Ans - 1995, 2002, and
2010 - present core functions, roles, responsibilities and relationships
integral to professional case management practice across the health care
continuum.
, Health Information Technology for Economic and Clinical Health Act of
2009 Right Ans - Part of the American Recovery and Reinvestment Act
of 2009, this allotted billions of dollars to the expansion as well as the
adoption of information technology to create a national network of
electronic health records.
National Transitions of Care Coalition Right Ans - Formed in 2006 by
Case Management Society of America and Sanofi to bring stakeholders
together to address solutions and tools to address gaps in continuity.
Became and independent organization in 2012.
Patient Protection and Affordable Care Act of 2010 Right Ans -
Provisions repeatedly focus on coordination of care and care transition
initiatives as integral to demonstration projects for community based care
transitions and outcomes reporting.
Case Management Society of America's definition of case managment
Right Ans - A collaborative process of assessment, planning , facilitation,
care coordination, evaluation and advocacy for options and services to
meet an individual's and family's comprehensive health needs through
communication and available resources to promote quality cost-effective
outcomes.
Philosophy Right Ans - A statement of belief that sets forth principles to
guide a program and the individual in their practice of that program
Case management philosophy Right Ans - The belief that when an
individual reaches the optimum level of wellness and functional capability
everyone benfits
Case Management framework Right Ans - Serves as a means for
achieving client wellness an autonomy through advocacy, communication,
education, identification of service resources and service facilitation.
12 Principles of case management Right Ans - 1. Client centric
collaborative approach 2. Facilitate self-determination and self-care
through the tenets of advocacy, shared decision making and education 3.
Holistic 4. Cultural competence 5. Evidence Based 6. Promote safety 7.
Promote integration of behavioral change science 8. Link with community
Liberty Mutual used case management to help with this population's cost
management in the 1940's. Right Ans - Workers' Compensation
Early public health case management efforts focused on these two areas.
Right Ans - Psychiatry and social work.
Following this event many insurance companies employed nurses and
social workers to take care of patients with multiple and complex injuries.
Right Ans - World War II
Intracorp Right Ans - Founded by CIGNA in 1966 for workers'
compensation; included both vocational rehab and nursing care
management; aimed at cost management
Health Maintenance Organization Act of 1973 Right Ans - Removed
restrictions and provided grants and loans to develop HMO alternatives to
traditional health care
The Older Act of 1978 Right Ans - Resulted in case management of
elders throughout the US
Case management and utilization review for medical necessity were
adopted into general insurance pools in this decade Right Ans - 1980's
Case Management Right Ans - A cost containment tool for managing
complex and catastrophically ill and injured patients. It is considered an
advanced practice of various healthcare professions.
Case Management Society of America Right Ans - Founded in 1995.
Published the first Standards of Practice for Case Management.
Standards of Practice for Case Management Right Ans - 1995, 2002, and
2010 - present core functions, roles, responsibilities and relationships
integral to professional case management practice across the health care
continuum.
, Health Information Technology for Economic and Clinical Health Act of
2009 Right Ans - Part of the American Recovery and Reinvestment Act
of 2009, this allotted billions of dollars to the expansion as well as the
adoption of information technology to create a national network of
electronic health records.
National Transitions of Care Coalition Right Ans - Formed in 2006 by
Case Management Society of America and Sanofi to bring stakeholders
together to address solutions and tools to address gaps in continuity.
Became and independent organization in 2012.
Patient Protection and Affordable Care Act of 2010 Right Ans -
Provisions repeatedly focus on coordination of care and care transition
initiatives as integral to demonstration projects for community based care
transitions and outcomes reporting.
Case Management Society of America's definition of case managment
Right Ans - A collaborative process of assessment, planning , facilitation,
care coordination, evaluation and advocacy for options and services to
meet an individual's and family's comprehensive health needs through
communication and available resources to promote quality cost-effective
outcomes.
Philosophy Right Ans - A statement of belief that sets forth principles to
guide a program and the individual in their practice of that program
Case management philosophy Right Ans - The belief that when an
individual reaches the optimum level of wellness and functional capability
everyone benfits
Case Management framework Right Ans - Serves as a means for
achieving client wellness an autonomy through advocacy, communication,
education, identification of service resources and service facilitation.
12 Principles of case management Right Ans - 1. Client centric
collaborative approach 2. Facilitate self-determination and self-care
through the tenets of advocacy, shared decision making and education 3.
Holistic 4. Cultural competence 5. Evidence Based 6. Promote safety 7.
Promote integration of behavioral change science 8. Link with community
