What Exhibitors Should Know About CMSA
Positively impacting and improving patient wellbeing and health care outcomes.

CASE MANAGEMENT is a collaborative process which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs through communication and available resources to promote quality costeffective outcomes.
Positively impacting and improving patient wellbeing and health care outcomes.

Positively impacting and improving patient wellbeing and health care outcomes.

Question: What Tasks Are Currently Included in Your Job Duties?
• Pre-certification
• Benefit Determination
• Risk Management
• Medical Legal Consultation
• Life Care Planning
• Disease Management
• Utilization Management
• Case Management
• Discharge Planning
• Health & Wellness Coaching
• Research
• IT or Data Services
Source: CMSA 2007 State of the Industry Survey
• Direct Patient Care/Education
• Product Development
• Disability Management
• Negotiation – contracts & fee schedules
• Telephonic/On-site Case
Management
• Medication Therapy
Management
• Education – patient, provider,
& staff
• Accreditation
• Telephonic Demand
Management
Positively impacting and improving patient wellbeing and health care outcomes.

• Health Care Reform
• Care Coordination
• Transitions of Care
• Patient Safety
• Medication Reconciliation
• Payment Alignment & Performance Measures
• New Models of Care
• Patient & Family Caregiver Engagement
• Collaborative Practice
Positively impacting and improving patient wellbeing and health care outcomes.

Transition Issues Dramatically
Impact Patient Care
Continuum
Case
Mgrs
Patient
ER ICU
OUTPATIENT:
• Home
• PCP
• Specialty
• Pharmacy
• Case Mgr.
• Care Giver
ED
Case Mgr In-Patient
SNF ALF
Hospital
Case Mgr
Patient
Managed
Care
Case
Mgr
Positively impacting and improving patient wellbeing and health care outcomes.

We Serve Many People Along the
Health Care Continuum
Positively impacting and improving patient wellbeing and health care outcomes.

MY JOB TITLE IS:
– Case Manager
– Care Manager
– Care Coordinator
– Discharge Planner
– Disease Manager
– Department Supervisor
– Department Manager
– Department Director
– Utilization Manager
– Other
• Social Worker
• Senior Care/Rehab
• Occupational Nurse
Source: CMSA 2007 State of the Industry Survey
Positively impacting and improving patient wellbeing and health care outcomes.

• Evolution of the SOP
• Definition of CM
• CM Practice Settings
• CM Roles, Functions,
Activities
• Components of the CM
Process
• Standards of Practice
• Glossary and Acronyms
• References
Positively impacting and improving patient wellbeing and health care outcomes.

• Today, case managers are in most elements of the payer and provider communities where the need to balance quality care and costeffective care exists.
• The process of case management begins with identification of high-cost, complex care individuals who meet criteria for and can benefit from case management services
Source: CMSA Standards of Practice
Positively impacting and improving patient wellbeing and health care outcomes.

Healthcare Reform – On The Horizon
• Baucus Call to Action – Strengthening the role of
Primary Care and Chronic Care Management
• H.R. 2773 – Supports the Transitional Care Model
• The Senate Health, Education, Labor and
Pensions (HELP) Committee released a “draft of a draft” of healthcare reform legislation.
– Group and individual health insurers must implement a reimbursement structure that provides incentives for:
• The implementation of case management, care coordination, and chronic disease management activities for treatment or services under the plan;
Positively impacting and improving patient wellbeing and health care outcomes.

Collaborative Care, Care Coordination and Transitions of Care Models
• Dr. Eric Coleman – Transition Coaching
• Dr. Mary Naylor – Transitional Care Model
• Dr. Chad Boult – Guided Care Nurses
• Medical Home Demonstration
• National Transitions of Care Coalition (NTOCC)
• American Geriatric Society
• National Coalition on Care Coordination (N3C)
Positively impacting and improving patient wellbeing and health care outcomes.

Developing
Care Coordination Measures
• CMS 9th SOW supports Care Coordination
– Care Pathways
• 2009 TJC Patient Safety Standard #8 enhanced Medication
Reconciliation to include patient and caregiver involvement and transition
– Documentation of process
• NQF developing Performance Measures for Care Coordination
– Call for Best Practices December 2008
– Measures Development in 2009
• URAC incorporating TOC principals in revised CM Standards
• AMA – PCPI Transitions of Care
– ACP/SHM/ABIM Foundation/PCPI will develop jointly practitioner-level performance measures for transitions of care
Positively impacting and improving patient wellbeing and health care outcomes.

Clinical & Administrative Transactions
Patient
Physician
Office
Advocate
Motivational
Interventions
Community
Health
Center
Facilitation
Assessment
Care Plan
Hospital
PBM
Case Manager
Health
Promotion
Increase
Productivit y
Specialist
Pharmacy Employer
Positively impacting and improving patient wellbeing and health care outcomes.

Case Management Society of America
CONNECTING YOU TO CASE MANAGERS
Positively impacting and improving patient wellbeing and health care outcomes.

• Currently approaching 12,000 members
– Additional 15,000 subscribers
– Over 200 company members
– 75 geographic chapters
• Presence across the continuum
– 34% in managed care/insurance
– 26% in acute care/hospital setting
– 12% in work comp/occupational health/employers
– 9% in government agencies/military
Positively impacting and improving patient wellbeing and health care outcomes.

Reaching Case Managers Year-Round
• Educational opportunities and events
– In-person and on-line
– With or without continuing education credits
• Tools and resources
• Increasing knowledge and case management effectiveness
Positively impacting and improving patient wellbeing and health care outcomes.

INCLUDED IN MEMBERSHIP
CMSA’s online educational resource offers programs to care managers and allied health professionals serving the care management industry.
COURSEWORK LEVELS
•
•
•
Basic
Intermediate
Advanced
• FREE CE and Non-CE Courses (CM/DM/UM)
• My Coursework
• Masters Level Coursework
• Other Resources
• Business Courses
Positively impacting and improving patient wellbeing and health care outcomes.

Case Management
Adherence Guidelines
• Adherence Assessment
• Motivational Interviewing
• Follow-up
• Using:
• Accessible Material
• Focused Learning
• Tools and Resources
Positively impacting and improving patient wellbeing and health care outcomes.

• Currently in second revision
• In 2006, launched first disease specific supplement:
– Diabetes
– DVT
– Depression
– Cardio metabolic risk
– COPD (in development)
• Translated into three languages
Positively impacting and improving patient wellbeing and health care outcomes.

• Guides used by case managers to help navigate assessment, treatment and intervention
• Designed to be mentoring and “as needed” training devices
• Can incorporate new clinical, assessment and intervention methods
• Advocate to the health care team
Positively impacting and improving patient wellbeing and health care outcomes.

• Access to attendee and membership lists
• Discounts for exhibit booths and other CMSA products
• Complimentary individual memberships and conference registrations
• Heightened visibility
Positively impacting and improving patient wellbeing and health care outcomes.

CMSA’S 20 th ANNIVERSARY
June 8 – 11, 2010
Walt Disney World
Coronado Springs Resort
Orlando, Florida www.cmsa.org/conference
Positively impacting and improving patient wellbeing and health care outcomes.

• Educational and Promotional Events
– CE Symposia
– Non-CE Symposia
• General Conference Sponsorships
– 12 months of promotion
• Website
• Print material
• E-communications
– Signage and recognition
Positively impacting and improving patient wellbeing and health care outcomes.

• Coast-to-Coast Party
Kick-Off Event
– Exclusive use of Disney’s Hollywood
Studios
– Unique branding and promotion opportunities
– Exclusive and wide-spread promotion of sponsors
• Disney’s Exhibitor
Concierge Service
– Theme Park Events & Tickets
– Entertainers
– Cutting edge AV and booth presentations
Positively impacting and improving patient wellbeing and health care outcomes.

• EXHIBIT BOOTHS: contact the Exhibit Management
Team for more information
• SPONSORSHIPS : available for all budgets and guidelines
• STRATEGIC
PACKAGES
Positively impacting and improving patient wellbeing and health care outcomes.

• MICHELLE KOCH
Director, Corporate Accounts mkoch@acminet.com
• LINDSAY HARP
Account Representative lharp@acminet.com
• J. MICHAEL HOEHN
Vice-President,
Business Development mhoehn@acminet.com
• HARRY ALBA
Corporate Accounts halba@comcast.net
• SYLVIA JOHNSON
Conference Coordinator sjohnson@acminet.com
• SHELLY GREENWOOD
Event Planner sgreenwood@acminet.com
Positively impacting and improving patient wellbeing and health care outcomes.

Thank You for Your Support of Case Management
Positively impacting and improving patient wellbeing and health care outcomes.