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Management of acute and chronic illness and disability

WEBDisability: 1) A physical or neurological deviation in an individual makeup. It may refer to a physical, mental or sensory condition. A disability may or may not be a handicap to an …

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URL: https://casemanagementstudyguide.com/ccm-knowledge-domains/healthcare-management-delivery/management-of-acute-and-chronic-illness-and-disability/

Rehabilitation service delivery systems

WEBOutpatient Rehabilitation- Patients travel to a clinic or hospital to attend sessions and then return home the same day. Typically, a therapy session lasts from 30 minutes to an …

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Chronic Care Model

WEBThe Chronic Care Model is a method of caring for people with chronic disease in the primary care setting. It encourages practical, supportive and evidenced-based chronic …

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Case management process and tools

WEBCase Management Body of Knowledge website defines the Case Management Process as “The context in which case managers provide health and human services to clients and …

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Healthcare delivery systems

WEBIntegrated delivery system (IDS) IDS’s are systems of healthcare that provide services across the continuum of care settings. Providers including physicians and hospitals are …

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Healthcare insurance principles

WEBHealth insurance insures against the risk of incurring medical expenses. For the health insurance company to be able to afford these expenses they have to know how much …

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Quality indicators

WEBClinical quality measures, or CQMs, are tools that help measure and track the quality of health care services provided. These measures use data associated with providers’ …

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Continuum of care

WEBContinuum of care. Continuum of Care: The continuum of care matches ongoing needs of the individuals being served by the case management process with the appropriate level …

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Cost containment principles

WEBWith traditional insurance, cost containment comes in the form of coinsurance, copayments and deductibles. These terms can often be confusing to the patient as well as the Case …

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Americans with Disabilities Act [ADA]

WEBThe Americans with Disabilities Act (ADA) prohibits discrimination against people with disabilities in employment, transportation, public accommodation, communications, and …

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Factors used to identify acuity or severity levels

WEBThe severity of the patients illness is only one factor in evaluating the acuity level of the patient. Other factors that may be taken into account include: comorbid conditions. …

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Managed care concepts and rules for reimbursement

WEBManaged Care: A system of healthcare delivery that aims to provide a generalized structure and focus when managing the use, access, cost, quality, and effectiveness of healthcare …

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Prospective payment systems and rules for reimbursement

WEBCCMC Definitions Related to Perspective Payment Systems. Prospective Payment System: A healthcare payment system used by the federal government since 1983 for …

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Are you eligible to take the CCM exam

WEBIf your license doesn’t qualify you to take the CCM, think about using your degree to apply instead. Just remember, your license needs to be active and current at …

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Roles and functions of case managers in various settings

WEBEnsure appropriate care. Negotiate for services. Monitor for compliance with treatment plan. Ensure appropriate level of care and care setting. Educate on healthcare benefit. …

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