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| benefits of case management: CMSA's Integrated Case Management Kathleen Fraser, MSN, MHA, RN-BC, CCM, CRRN, Rebecca Perez, MSN, RN, CCM, FCM, Corine Latour, PhD, RN, 2018-01-28 Written by case managers for case managers, this reference manual for nurses and other health professionals presents a CMSA tested approach towards systematically integrating physical and mental health case management principles and assessment tools. Since the health care field has undergone major changes such as the passing of the Patient Protection and Affordable Care Act, Mental Health Parity, Transition of Care & Chronic Care Management and the Medicare Act and CHIP Authorization Act (MACRA), health care workers must competently know how to integrate those new regulations, describe alternative payment options, and implement requirements for greater patient and family assessment, care planning, and care coordination in their practice. CMSA’s Integrated Case Management delves into the role of the case manager and unpacks how case managers assess and treat complex patients. These are patients who may be challenged with medical and behavioral conditions, poor access to care services, as well as chronic illnesses and disabilities, and require multidisciplinary care to regain health and function. With a wealth of information on regulatory requirements, new models of care, integration of services, digital and telemedicine, and new performance measures that are clearly defined for nurses in nursing terminology, chapters outline the steps needed to begin, implement, and use the interventions of the Integrated Case Management approach. All content aligns with the newly revised 2017 Model Care Act, CMSA Standards of Practice 2016 as well as the CMSA Core Curriculum for Case Management Third Edition. |
| benefits of case management: Health and Human Services Issues United States. General Accounting Office, 1993 Discussing major policy, management, and program issues facing Congress and the Clinton administration in the area of health and human services, this pamphlet provides recommendations for the Department of Health and Human Services (HHS) regarding the social security system, the welfare system, preventing child abuse, and safeguarding the nation's food supply. Following an overview of important issues facing the nation, the second section suggests steps to bolster public confidence in the social security system, including building the system's trust fund by increasing contribution levels and modernizing computer systems. The next section provides recommendations for continuing the welfare reform movement and the implementation of the Family Support Act, such as developing automated data systems to effectively manage caseloads, setting goal-oriented program performance standards, and identifying and sharing effective initiatives between states. The fourth section suggests that HHS provide states with greater flexibility in using government funds to prevent child abuse through early intervention and that a national foster care system be developed to provide outcome-oriented data on child welfare services. The final section proposes that an agency-wide system for tracking regulation development be implemented in the Food and Drug Administration to improve agency effectiveness and better allocate existing resources. Includes references for 22 related GAO products. (BCY). |
| benefits of case management: Case Management Suzanne K. Powell, Hussein M. Tahan, 2018-02-26 Prepare for a new career as a case manager—or just upgrade your skills to a whole new level—with the newly updated Case Management: A Practical Guide for Education and Practice, 4th Edition. Ideal for case management certification (CCMC) exam preparation, this is a thorough review of the case manager’s many roles and skills, from acute to post-acute care. Whether you are a nurse transitioning to case management or already active in it, this is your road map to coordinating successful patient care, from hospital to home. Build a strong case management career foundation, with expert, evidence-based direction: NEW chapter on case manager orientation programs that offers orientation checklists, competency assessment, and learning profiles, with available online tools NEW topics on current practice issues and developments, including the impact of the Patient Protection and Affordable Care Act and value-based care NEW content on experiential, problem-based learning—learning practices, training programs, case management team professional development Offers in-depth, evidence-based guidance on: The case manager’s roles, functions, and tasks Key concepts—quality management and outcomes evaluation, legal and ethical considerations, case management process, utilization management, transitions of care The role of the nurse case manager versus social worker role Strategies that ensure effectiveness of case management models Coordinating care, protecting privacy and confidentiality, health insurance benefit analysis, practice standards The Case Management Code of Professional Conduct, accreditation agencies and standards, specialty board certifications Management of resources and reimbursement concepts Case management in various settings—acute care, emergency department, admissions, perioperative services, disease management, insurance case management, palliative care, end-of-life care, hospice, home health care, physician groups, public health/community-based care, rehabilitation Ideal preparation for the CCMC exam—offers a large portion of CCMC exam content—and for Continuing Education Unit (CEU) for Case Management study A must-have desk reference that offers plentiful case studies—considered to be “the bible” of case management |
| benefits of case management: Social Work Case Management Betsy Vourlekis, 2017-07-05 This new practice text provides a series of readings focusing on case management in a number of fields and in a variety of settings with different client populations. Each chapter examines a major component of case management practice by presenting information about an innovative program from a different location around the country. In conjunction, these readings provide a road map to social work case management.In addition to offering up-to-date practice approaches and examining the functions and skills of case management in depth, the authors provide the policy information needed for putting this traditional form of social work practice into today's service delivery context. |
| benefits of case management: Case Management Shilpa Ross, Natasha Curry, Nick Goodwin, King's Fund (London, England), 2011 |
| benefits of case management: Foundations of Case Management Deanna Cooper Gillingham, 2021-10-16 |
| benefits of case management: Case Management Mary Hubbard Linz, Patricia L. McAnally, Colleen Ann Wieck, 1989 |
| benefits of case management: Case Management Arthur J. Frankel, Sheldon Gelman, Diane K. Pastor, 2019 Over the course of twenty years and across three editions, this text has approached case management as both an art and a science by providing students and practitioners with the basics of case management theory, skills, and applications. This fourth edition, which focuses on both the social work and nursing professions, offers trainers, instructors, and students detailed information about how case management is delivered, major issues encountered in practice, how services are affected by different populations, and the unique skills that are required by case managers in order to be effective. Chapter exercises and numerous case examples help readers practice some of the skills associated with the content offered.Case Management is unique in that it brings together the major professions that conduct case management in the United States. It is focused on skill learning more than on theory, and discusses not only the importance of case management in the current social work and medical milieu, but also the challenges that case managers face in helping clients. In addition, the text offers a model for integrated case management between professions and in numerous settings, including nursing centers, community mental health facilities, and criminal justice centers. |
| benefits of case management: Treatment Alternatives to Street Crime James A. Inciardi, Duane C. McBride, 1994-03 Treatment Alternatives to Street Crime (TASC) provides an objective bridge between two separate institutions: the criminal justice system and the drug treatment community. Under TASC, community-based supervision is made available to drug-involved individuals who would otherwise burden the justice system with their persistent drug-associated criminality. TASC operates in more than 100 jurisdictions. Covers: empirical and theoretical foundations of TASC; early years of TASC; early TASC evaluations; the current structure of TASC; and the future of TASC. References. |
| benefits of case management: CCM Certification Made Easy Andrea Morris, 2016-07-20 We are extremely pleased to tell you that CCM Certification Made Easy has been updated to it's Second Edition, and includes all the new material recently added to the CCM Exam. Every subdomain is covered on the exam. CCM Certification Made Easy is clearly the most complete CCM Exam prep book you can buy.Up to date - every area has been revisited for this updated edition to keep pace with the substantial changes in healthcare and the CCM Exam.Includes a condensed versions of the CCMC's Glossary of Terms that are an essential resource to pass the CCM Exam.Includes a website link to download a free companion workbook and study strategies that countless case managers have used to pass the CCM Exam at no extra charge. |
| benefits of case management: Case Management Models, Second Edition Karen Zander, 2017-06-28 Explains the differences between case management and social work and the ways in which case management functions have evolved over time. Case management is continuously evolving to meet the needs of patients and manage the quality, financial, and legal risks health care systems and accountable care organizations (ACO) face. |
| benefits of case management: Solution-Focused Case Management Robert G. Blundo, PhD, LCSW, Joel K Simon, MSW, ACSW, BCD, 2015-11-06 “Blundo and Simon have successfully outlined how a solution-focused perspective can be a powerful tool for case managers. Their understanding and presentation is based upon practice scenarios that are real and applied...They clearly demonstrate the impact of ‘thinking and language’ and the importance of building a collaborative relationship with clients. Their work challenges the traditional theory-driven interventions that focus on problems and arrive at a diagnosis . They encourage a ‘shift’ to a co-constructive partnership that requires a practitioner to respect that clients are ‘experts of their own lives’...They provide a clear step-wise discussion of techniques and strategies that can be employed working with individuals and families in case management settings. This book is a must read.” -Lawrence T. Force, PhD. LCSW-R Professor of Psychology, Mount Saint Mary College, Newburgh, NY From the Foreword Solution-focused practice is a paradigm that stresses client abilities, strengths, and individual goals rather than disability. Written by a team of educator/practitioners noted for their expertise in solution-focused therapy, this “how-to” text for social work, counseling, and psychology students guides current and future case managers in learning this strengths-based, collaborative approach to case management. It discusses both the philosophical basis for solution-focused casework and demonstrates how it is ideally suited for the case management process. The book is based on teaching materials the authors have developed and used in their classes and workshops with undergraduate and graduate students and professionals. The text incorporates new research and theoretical developments in solution-focused therapy as well as actual practice scenarios demonstrating the process of building a collaborative relationship with individual clients and families. Replete with strategies and tools for practicing solution-focused case management, the text describes such essential skills as identifying goals, monitoring progress, working with other agencies, and transitioning out of treatment. It discusses issues related to ethical practice and presents strategies for self-care. Additionally, the book addresses diversity and social justice and their relationships to solution-focused practice. Student exercises help to reinforce knowledge. The text will assist case managers in a variety of settings—hospitals, nursing homes, rehabilitation facilities, community-based mental health agencies, schools, prisons, court systems, and shelters for the homeless and victims of domestic violence—to partner with their clients towards finding strengths-based and solution-focused approaches to resolving issues in a positive way. Key Features: Authored by noted experts in solution-focused education and practice Facilitates a reframing of casework and case management around client strengths and resources Provides specific case examples that allow readers to troubleshoot and apply solution-focused principles to practice Includes student exercises throughout the book |
| benefits of case management: CMSA Core Curriculum for Case Management , 2008 This text contains the core body of knowledge for case management practice as delineated by the Case Management Society of America (CMSA), the largest professional organization of case managers. The core curriculum provides a synthesis of case management evolution, and presents essential elements, concepts, and vision for current and future case management practice. This edition is significantly expanded to reflect the dynamic changes taking place in case management. Each chapter is organized in a consistent format that includes learning objectives; introduction; important terms and concepts; key definitions; and references. |
| benefits of case management: The Strengths Model Charles A. Rapp, Richard J. Goscha, 2006 Second edition grounds the strengths model of case management within the recovery paradigm and details evidence-based guidelines for practice. Describes the conceptual underpinnings, theory, empirical support, principles, and practice methods that comprise the strengths model of case management--Provided by publisher. |
| benefits of case management: Social Work Case Management Michael J. Holosko, 2017-01-30 Social Work Case Management: Case Studies From the Frontlines by Michael J. Holosko is an innovative book that equips readers with the knowledge and skills they need to be effective case management practitioners in a variety of health and human service organizations. A must-read for students and professionals in social work, this important work introduces a unique Task-Centered Case Management Model built around the unifying principles of the profession—person-in-environment, strengths-based work, and ecological perspective. Over twenty case studies by case managers and professionals offer innovative practice insights, illustrating the practice roles and responsibilities of today's case managers and the realities of conducting case management in today’s growing, exciting, and challenging field. |
| benefits of case management: Case Management Suzanne K. Powell, 2000 The Second Edition of this comprehensive how to text has been completely revised and updated. This text outlines the basics of case management and illustrates some of the pitfalls encountered in the field of case management. The book provides information on the new Case Management Standards, supplies standard definitions and guidelines of case management for the practicing case manager, and presents information on caring for clients in a wide variety of health care settings. New to this edition--chapters focusing on Quality Reviews and Risk Management with a strong emphasis on Continuous Quality Improvement (CQI), ethical and legal issues, and various case studies. |
| benefits of case management: Digitalization in Healthcare Patrick Glauner, Philipp Plugmann, Guido Lerzynski, 2021-03-13 Digital technologies are currently dramatically changing healthcare. This book introduces the reader to the latest digital innovations in healthcare in fields such as artificial intelligence, points out new ways in patient care and describes the limits of its application. It also offers essential guidance in the form of structured and authoritative contributions by domain experts spanning from artificial intelligence to hospital management to radiology to dentistry to preventive medicine. Furthermore, it shares ideas and experiences of industry veterans, in particular on how IT-driven solutions could solve long-standing issues in the fields of healthcare and hospitalization. It also gives advice on what new digital technologies to consider for becoming a healthcare market leader in the future. Taken together, these contributions provide a “road map” to guide decision makers, physicians, academics, industry representatives and other interested readers to understand the large impact of digital technology on healthcare today and its enormous potential for future development. |
| benefits of case management: Addiction Counseling Competencies , 1998 |
| benefits of case management: Case Management for Mentally Ill Patients Harris, 1993-04-01 Case Management-what is it and how does it fit in the system of mental health care for severely mentally ill patients? Four popular case management systems, each emerging from a distinct theory of human growth and development, answer these long debated questions. Case Management for Mentally Ill Patientswill prove highly useful to mental health students and practitioners, university educators, and professionals providing hands-on help in obtaining a wide range of services including insurance, housing, rehabilitation, general medical psychiatric care, legal services and entitlements, and employment. Maxine Harrisand Helen Bergmanare co-founders and co-directors of Community Connections, Inc., in Washington, DC. |
| benefits of case management: The Hospital Case Management Orientation Manual Peggy Rossi, Bsn, Mpa, CCM, Karen Zander, 2014-06-12 The Hospital Case Management Orientation Manual Guide is a comprehensive resource that supplements of initial training for new case managers. This book explains what to document, where to document it to ensure appropriate level of care and reimbursement, and how to avoid unnecessary denials. This book's focus is utilization management, discharge planning, and relevant CMS regulations. It can help new case managers learn how to perform their jobs effectively on their own time. It can also serve as a wide-ranging resource for more experienced case managers, particularly those whose training was less than adequate. |
| benefits of case management: A Practical Guide to Case Management in Higher Education Makenzie Schiemann, Jamie Molnar, 2019-11 The Practical Guide to Case Management in Higher Education offers a comprehensive examination of the growing field of higher education case management. As the first ever book of its kind, this text provides the foundations for the work, defines standards of practice, and includes specific strategies case managers can utilize for a variety of student populations and concerns. Drawing from current experts in the field as well as the most cutting edge research on the work, this functional guide delivers key insights into best practice recommendations as well as practical, real-world examples of protocols and processes for the work. |
| benefits of case management: Ask a Manager Alison Green, 2018-05-01 From the creator of the popular website Ask a Manager and New York’s work-advice columnist comes a witty, practical guide to 200 difficult professional conversations—featuring all-new advice! There’s a reason Alison Green has been called “the Dear Abby of the work world.” Ten years as a workplace-advice columnist have taught her that people avoid awkward conversations in the office because they simply don’t know what to say. Thankfully, Green does—and in this incredibly helpful book, she tackles the tough discussions you may need to have during your career. You’ll learn what to say when • coworkers push their work on you—then take credit for it • you accidentally trash-talk someone in an email then hit “reply all” • you’re being micromanaged—or not being managed at all • you catch a colleague in a lie • your boss seems unhappy with your work • your cubemate’s loud speakerphone is making you homicidal • you got drunk at the holiday party Praise for Ask a Manager “A must-read for anyone who works . . . [Alison Green’s] advice boils down to the idea that you should be professional (even when others are not) and that communicating in a straightforward manner with candor and kindness will get you far, no matter where you work.”—Booklist (starred review) “The author’s friendly, warm, no-nonsense writing is a pleasure to read, and her advice can be widely applied to relationships in all areas of readers’ lives. Ideal for anyone new to the job market or new to management, or anyone hoping to improve their work experience.”—Library Journal (starred review) “I am a huge fan of Alison Green’s Ask a Manager column. This book is even better. It teaches us how to deal with many of the most vexing big and little problems in our workplaces—and to do so with grace, confidence, and a sense of humor.”—Robert Sutton, Stanford professor and author of The No Asshole Rule and The Asshole Survival Guide “Ask a Manager is the ultimate playbook for navigating the traditional workforce in a diplomatic but firm way.”—Erin Lowry, author of Broke Millennial: Stop Scraping By and Get Your Financial Life Together |
| benefits of case management: The Necessary Art of Persuasion Jay A. Conger, 2008-09-08 In an age when managers can no longer rely on formal power, persuading people is more important than ever. Persuasion is a process of learning from colleagues and employees and negotiating shared solutions to solving problems and achieving goals. In The Necessary Art of Persuasion, Jay Conger describes four essential components of persuasion and explains how to master them, providing the information you need to fulfill your managerial mandate: getting work done through others. |
| benefits of case management: The Case Manager’s Handbook Catherine M. Mullahy, 2016-05-23 Written by renowned author Catherine M. Mullahy, The Case Manager’s Handbook, Sixth Edition is an indispensable guide for case managers. Presented in an accessible and conversational style, this practical resource helps case managers learn the fundamentals, study for the Certified Case Manager (CCM) exam, and advance their careers after the exam. Completely updated and enhanced with information on the latest developments affecting case management, it reflects the rapidly changing healthcare landscape, including the significant effects of the Affordable Care Act (ACA). The Sixth Edition includes new chapters on pediatric case management, workers’ compensation case management, key factors driving today’s healthcare system, the case manager’s role in the era of value-based health care, case management and healthcare provider strategies for managing the high-risk or high-cost patient, and transformative healthcare approaches for the millennial generation. |
| benefits of case management: ADKAR Jeff Hiatt, 2006 In his first complete text on the ADKAR model, Jeff Hiatt explains the origin of the model and explores what drives each building block of ADKAR. Learn how to build awareness, create desire, develop knowledge, foster ability and reinforce changes in your organization. The ADKAR Model is changing how we think about managing the people side of change, and provides a powerful foundation to help you succeed at change. |
| benefits of case management: Conditions of Participation for Hospitals United States. Social Security Administration, 1966 |
| benefits of case management: The Case Manager's Handbook Catherine M. Mullahy, 2013-06-20 Written by renowned author Catherine Mullahy, The Case Manager’s Handbook, Fifth Edition is the ultimate how-to guide for case managers. This practical resource helps case managers build fundamentals, study for the Certified Case Manager (CCM) exam, and most importantly, advance their careers after the exam. Written for all professionals in all practice settings in case management, it uses real-life examples and an easy-to-read, conversational style to examine the case management process while presenting practical procedural information. An excellent daily reference and training guide for new case managers and seasoned professionals in various setting, The Case Manager’s Handbook, Fifth Edition is the “go-to” resource for facing the day-to-day challenges of case management, especially as the nation navigates through the many changes introduced by the landmark Patient Protection and Affordable Care Act. Significantly updated and revised, it contains eight new chapters: * Hospital Case Management: Changing Roles and Transitions of Care * Patient Centered Medical Home, ACOs, Health Exchanges * Evidence-Based Practice * Public Sector Reimbursement * Predictive Modeling * Pain Management * Health Technology, Trends, and Implications for Case Managers * The Affordable Care Act of 2010: Implications for Case Managers Included with each new print book is an Access Code for a Navigate Companion Website for students with objectives, multiple choice questions, and bonus appendices. |
| benefits of case management: Promoting the Health of the Community Julie Ann St. John, Susan L. Mayfield-Johnson, Wandy D. Hernández-Gordon, 2021-03-22 Community health workers (CHWs) are an increasingly important member of the healthcare and public health professions who help build primary care capacity. Yet, in spite of the exponential growth of CHW interventions, CHW training programs, and CHW certification and credentialing by state agencies, a gap persists in the literature regarding current CHW roles and skills, scope of practice, CHW job settings, and national standards. This collection of contributions addresses this gap by providing information, in a single volume, about CHWs, the roles CHWs play as change agents in their communities, integration of CHWs into healthcare teams, and support and recognition of the CHW profession. The book supports the CHW definition as defined by the American Public Health Association (APHA), Community Health Worker Section (2013), which states, “A community health worker is a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.” The scope of the text follows the framework of the nationally recognized roles of CHWs that came out of a national consensus-building project called “The Community Health Worker (CHW) Core Consensus (C3) Project”. Topics explored among the chapters include: Cultural Mediation Among Individuals, Communities, and Health and Social Service Systems Care Coordination, Case Management, and System Navigation Advocating for Individuals and Communities Building Individual and Community Capacity Implementing Individual and Community Assessments Participating in Evaluation and Research Uniting the Workforce: Building Capacity for a National Association of Community Health Workers Promoting the Health of the Community is a must-have resource for CHWs, those interested in CHW scope of practice and/or certification/credentialing, anyone interested in becoming a CHW, policy-makers, CHW payer systems, CHW supervisors, CHW employers, CHW instructors/trainers, CHW advocates/supporters, and communities served by CHWs. |
| benefits of case management: Nursing Case Management Elaine Cohen, Toni G. Cesta, 2004-08-26 This classic resource offers complete coverage of nursing case management - from theoretical background and historical perspective to practical applications and how the field is changing to meet the challenges of today's health care environment. It focuses on the implementation of various case management models used throughout the United States and abroad. Key topics include the impact of public policy on health care; understanding the effects of health care reimbursement and its application at the patient level; throughput and capacity management; the impact of the revenue cycle; compliance and regulatory issues; and principles needed to improve case manager-client interaction. This helpful resource is designed to help nurse case managers assess their organization's readiness for case management, prepare and implement a plan to achieve necessary improvements and evaluate the plan's success. Includes numerous proven case management models currently being used in institutions across the country Organized to take the nursing case manager on a journey from the historical development of nursing case management to the successful implementation of a case management program Offers detailed guidance for planning, implementing, and evaluating a case management program Outlines the planning process with information on key topics such as analysis of the organization, the role of the organization's members, selection criteria for new case managers, case management education, credentialing, and partnerships Features guidelines for implementing a case management program with information on ethical issues, technology, compliance, and regulatory issues Addresses the evaluation component of developing and implementing a case management program by presenting information on outcomes, research, documentation, continuous quality improvement, measuring cost effectiveness, care continuum, and evidence-based practice Presents acute care and community based models of case management Highlights the evolution of collaborative models of case management, addressing key elements of joint decision-making, shared accountability, and interdisciplinary systems of care Addresses health care delivery through case management and public policy by presenting current legislative issues and their affect on both health care reimbursement and the application of care at the patient level Presents the insights, experiences, and advice of nursing administrators who have researched and successfully implemented nursing case management programs in various facilities |
| benefits of case management: Emergency Department Case Management, Second Edition Kathleen Walsh, Karen Zander, 2014-11-14 From defining goals, clarifying roles, and understanding the necessary knowledge and skills required, Emergency Department Case Management: The Compendium of Best Practices, 2nd Edition will ensure that ED case management staff have a solid and sustainable foundation in place. After exploring models and reviewing emergency department infrastructure, this compendium will help readers outline key partnerships, present multiple options for case finding, tackle observation status accurately, address quality and evaluation issues, and identify ways ED RN case managers and social workers coordinate care for complex cases, such as pediatric, psychiatric, homeless, and uninsured populations. In addition to many new tools, this book is also packed with more than 20 detailed spotlights and case studies discussing ED case management strategies, best practices, and experiences of ED professionals from across the country. The new edition includes: The presence of case management RNs and Social Workers in emergency departments (ED) has become a standard since the first edition of this text was published in 2007. Ever-expanding and changing regulations for EDs and hospitals have emerged, while best practices have evolved to address these challenges. This new edition discusses these changes and provides updated guidance on running a compliant, effective, and efficient case management team in the ED. It also provides insight on adapting the role of case management based on unique ED patient populations and helps ED case managers stay ahead of the curve by examining what lies ahead in their profession. |
| benefits of case management: Workers' Compensation Subrogation In All 50 States - Fifth Edition Gary L. Wickert, 2012-04-01 Workers' compensation subrogation continues to change and adapt, as trial lawyers prod its weak points and capitalize on confusing areas of the law. There have been numerous changes in workers' compensation statutes and case law in many states since the last edition. This edition includes an exhausting survey and detailed explanation of the crazy status of employer contribution in Illinois, which includes a step-by-step exposition of how contractual indemnity and the Kotecki cap play a role in expanded employer liability in Illinois workers' compensation subrogation cases. It covers the many nuances of Naig and Reverse-Naig settlements under Minnesota law, including an analysis of who has what burdens of proof and the effect such a settlement has on the remaining third-party case tried to a jury. In light of the landmark Missouri Court of Appeals decision in Robinson v. Hooker, the liability of co-employees in Missouri and surrounding states have been covered in greater detail. The concept of co-employee liability for acts which are intentional or committed outside of the course and scope of employment has been added in several states. New case law and explanations were added to the Texas chapter with regard to subrogating against UM/UIM policies, including arguments with regard to the efficacy of UM/UIM exclusionary policy language and the ability to subrogate against a UM/UIM policy actually issued by the same carrier insuring for workers' compensation coverage. West Virginia completely revised their subrogation statute and created a new statute relating to the statutory employer status of primary contractors and subcontractors on construction sites, limiting when and how primary contractors can become legitimate third parties for purposes of subrogation. Chapter 7, Contractual Limitations to Subrogation has been completely overhauled to include new statutes and case law for every state to assist practitioners in determining the law applicable when there is an alleged applicable waiver of subrogation which might otherwise destroy subrogation. A new Chapter 12 has been added, which focuses on jurisdiction of workers' compensation third-party actions taking a broad look at 28 U.S.C. § 1441, which prohibits removal of cases arising under state workers' compensation laws. A carrier now has the ability to prevent cases from being removed from favorable venues in state court to less favorable federal court venues - an attractive option for plaintiffs' attorneys with whom subrogated carriers can negotiate with for stipulations and concessions on their subrogation interests in exchange for maintaining a case in state court. This edition also expands on which states do and do not hold workers' compensation to be primary. Combined with more than 100 new case decisions, this Fifth Edition is the most complete and up-to-date edition yet. Workers' Compensation Subrogation is the most complete and thorough treatise covering workers' compensation subrogation ever published. There are very few areas in which the laws of each state vary more and are applied as differently, then in the area of workers' compensation subrogation. This book is intended to introduce the workers' compensation claims handler, in-house counsel, and subrogation professionals to some of the more esoteric and complex subrogation issues encountered in today's workers' compensation insurance subrogation marketplace. It covers the following issues in all 50 states: • Allocating Third Party Recoveries • Attorney's Fees • Borrowed Servant Doctrine • Conversion of Workers' Compensation Liens • Costs and Expenses • Dual Capacity Doctrine • Equitable Subrogation/Contribution • Exclusivity Rule Barring Action Against Employer • How To Calculate Your Credit/Advance and How It Is Applied In Each State • Intentional Acts • Joint Ventures • Made Whole Doctrine As Applied To Workers' Compensation Subrogation • Necessity of Intervention • Lien Reduction Statutes • Staff Leasing Services and Temporary Employment Agencies • Statutory Subrogation Rights • Subrogating Against UM/UIM Benefits • Subrogating In Medical Malpractice Cases • Subrogating In Legal Malpractice Cases • Waivers of Subrogation • Who Qualifies As A Third Party • Other Workers' Compensation Subrogation-Related Issues In addition to being an excellent primer on workers' compensation subrogation, suitable for both the new subrogation professional and the seasoned veteran, the book also contains a detailed synopsis of the workers' compensation subrogation laws in each of the 50 states. It is a must for anyone with multi-state subrogation responsibilities. Complete with diagrams, references and thousands of footnotes, this is the most ambitious workers' compensation subrogation project ever undertaken. The following issues and topics are covered in detail for each of the 50 states: Statutory Subrogation Rights • Identifies the statutory authority for workers' compensation subrogation in that state. • Discusses the purpose/legislative intent of the statute. • Is an election necessary by the worker? • Who can bring a third party action (plaintiff, carrier, employer, or all of the above)? • When and must a third party action be brought? • What are the rights of a carrier to intervene in an existing third party action filed by a worker? • Will a worker's compensation carrier's subrogation interest be barred if not brought timely? Third Parties • Who can be sued as third parties in a third party action? • Can a co-employee be sued and under what circumstances? • Can an uninsured/underinsured carrier be a third party under the laws of that state? • Is there a dual capacity or borrowed servant doctrine which somehow affects the ability of a worker's compensation carrier to effectively subrogate? • What is the state's workers' compensation bar? • Are there any specific restrictions regarding subrogation against a subcontractor or an employee of a subcontractor in a construction situation? • Under what circumstances can the employer be sued? • Can a carrier subrogate to the benefits of a recovery in a legal or medical malpractice action? Allocation of Third Party Recovery • How and when does the carrier recover its subrogated interest? • Does the carrier recover past benefits only or also the present value of future benefits which it owes under the Workers' Compensation Act of that state? • Is there a formula used to determine how a third party recovery is allocated? • What happens to the total recovery and how is it applied? • Can a carrier recover benefits paid by a third party or recovered in a third party action which relate to loss of consortium, or non-economic damages such as pain and suffering, mental anguish, or punitive damages? • Does the employer's negligence reduce the recovery by the worker or carrier? Attorneys' Fees/Costs • Can the plaintiff's attorney recover attorneys' fees and/or costs out of the carrier's subrogated recovery and under what circumstances? • How are attorneys' fees and costs handled if the carrier is also represented by subrogation counsel, intervenes into the third party action and actively represents its interest? • What if the carrier isn't represented? • Can a plaintiff's attorney recover attorneys' fees based on the value of past benefits only or will he be able to recover attorneys' fees based on the future benefits/credit recovered by the carrier? • Must a carrier bear its proportionate share of expenses as many states require, and what does that really mean? Credit/Advance • Can a carrier take a vacation from paying workers' compensation benefits once a worker makes a third party recovery? • How is the credit calculated under state law? • Does the carrier have to do anything special to obtain the credit, such as filing with the Workers' Compensation Commission? • Does the carrier get a credit toward future compensation benefits it owes or does it actually get to collect the present value of the future benefits it owes and still be obligated to pay the scheduled benefits in the future? Statutes of Limitation • What are the applicable statutes of limitation or statutes of repose that may be applicable to third party subrogation actions? Related Subrogation Issues • Are there any other issues or statutes which affect a worker's compensation carrier's right of subrogation, such as the made whole doctrine, common fund doctrine, or anti-subrogation statutes? • Are there any lien reduction statutes, such as those existing in Indiana, which affect a worker's compensation carrier's right of recovery? • Does the state have any no-fault laws which complicate workers' compensation subrogation involving an automobile accident, such as exist in Michigan and Colorado? • What are the carrier's options if the worker and his attorney simply refuse to repay a worker's compensation carrier's lien after settling a third party action? • If the worker fails to repay the carrier, is there a cause of action for conversion of a carrier's subrogation interest or may the carrier still proceed against the third party tortfeasor to recover its subrogation interest? |
| benefits of case management: Practice of Case Management David P. Moxley, 1989 The Practice of Case Management in the Human Services offers a succinct yet comprehensive guide to carrying out a case manager's responsibilities. The author explores assessment of the service needs of the client, facilitating the client's contact with the appropriate institutions and services, monitoring the quality of services provided to the client, and taking action when the client's needs are not met. He also considers the therapeutic role required when needs are not met because the problems are indigenous to the client. Providing an integrated look at practice technologies applicable to a variety of practice areas, the volume is appropriate for both preservice and inservice education in the field of human servi |
| benefits of case management: Optimizing the Physician Advisor in Case Management Mark S. Michelman, Sharon Mass, Donna Ukanowicz, 2008-11 Foster effective relationships between case management and physicians with a strong physician advisor program. With increasing federal compliance regulations, there has never been a greater need to have a physician advisor (PA) on staff to provide your case management team with more support to achieve your organizational goals. Whether you're building a new PA program or want to revitalize an existing one, the new HCPro book Optimizing the Physician Advisor in Case Management: A Guide to Creating and Sustaining Measurable Program Results delivers the guidance you need to improve the chain of communication across the continuum of care. Written by Mark Michelman, MD, MBA, Sharon Mass, PhD, LCSW, ACM, and Donna Ukanowicz, MS, RN, ACM, the book combines the perspectives of a physician advisor, nursing case manager, and social work case manager. The book is the industry's first resource that provides: Easy-to-follow steps to create or revamp your program Tips to recruit and train PAs Strategies for defining measurable goals and effective PA responsibilities Analysis methods for evaluating need and justifying resources Metrics to measure your success A CD-ROM loaded with adaptable tools and forms |
| benefits of case management: Competitive Employment Paul Wehman, 1981 Ce livre comprend un profil du mouvement de l'intégration au travail et du Supported employment avec une perspective historique, une déclaration des orientations nécessaires à l'intégration sociale, des stratégies d'iontervention reliées à une approche behavioriste sur l'enseignement professionnel et des recommandations pour l'application de programme d'intégration au travail. |
| benefits of case management: Michigan Court Rules Kelly Stephen Searl, William C. Searl, 1922 |
| benefits of case management: Principles-Focused Evaluation Michael Quinn Patton, 2017-09-28 How can programs and organizations ensure they are adhering to core principles--and assess whether doing so is yielding desired results? From evaluation pioneer Michael Quinn Patton, this book introduces the principles-focused evaluation (P-FE) approach and demonstrates its relevance and application in a range of settings. Patton explains why principles matter for program development and evaluation and how they can serve as a rudder to navigate the uncertainties, turbulence, and emergent challenges of complex dynamic environments. In-depth exemplars illustrate how the unique GUIDE framework is used to determine whether principles provide meaningful guidance (G) and are useful (U), inspiring (I), developmentally adaptable (D), and evaluable (E). User-friendly features include rubrics, a P-FE checklist, firsthand reflections and examples from experienced P-FE practitioners, sidebars and summary tables, and end-of-chapter application exercises. ÿ |
| benefits of case management: Oxford Textbook of Community Mental Health Graham Thornicroft, 2011-08-18 Community mental health care has evolved as a discipline over the past 50 years, and within the past 20 years, there have been major developments across the world. The Oxford Textbook of Community Mental Health is the most comprehensive and authoritative review published in the field, written by an international and interdisciplinary team. |
| benefits of case management: Patient Safety and Quality Ronda Hughes, 2008 Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043). - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/ |
| benefits of case management: National Code of Ethics for Case Management Scott W. T. Trueman, Frieda Marfleet, 2012 |
| benefits of case management: Mental Illness in General Health Care T. Bedirhan Üstün, Norman Sartorius, 1995-06-15 This book presents the largest international study of psychological disorders seen in primary health care. Centres in fourteen countries participated in this investigation, including Brazil, Chile, China, India, Nigeria and the USA as well as several European countries. The study has shown how people with mental disorders present their problems to doctors and how likely their disorders are to be detected and treated. |
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