Discharge planning: a collaboration between provider and payer case managers using Medicare's Conditions of Participation.
Discharge planning is a legally mandated function for hospitals and is one of the "basic" hospital roles as outlined in Medicare's Conditions of Participation. This article will define discharge planning; describe the steps in the discharge planning process; list rules and regulations that influence discharge planning in hospitals; and compare hospital-based actions with payer-based actions when planning discharges. Case managers who work for payers interact with hospital-based case managers to facilitate the discharge planning process for patients. Those who form this patient-provider-payer triangle will benefit by reviewing the dynamics of the discharge planning process.
Birmingham
Jackie
J
Curaspan Inc., 11 Marbern Drive, Suffield, CT 06078, USA. jbirmingham@curaspan.com
D019090:Case Management / Q000458:organization & administration*; D003299:Cooperative Behavior; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000592:standards*; D008403:Mass Screening / Q000458:organization & administration; D006278:Medicare / Q000458:organization & administration*; D020380:Needs Assessment / Q000458:organization & administration; D010348:Patient Care Team / Q000458:organization & administration; D010351:Patient Discharge / Q000592:standards*; D010564:Personnel, Hospital / Q000523:psychology / Q000592:standards*; D017410:Practice Guidelines as Topic; D014481:United States