Case management: two regulations with coexisting functions (utilization review + discharge planning = case management).
Some hospitals have maintained a balance of the two mandated functions, utilization review and discharge planning, that directly affect the work of case management. Others have leaned more toward the fiscally based utilization review over the needs-based function of discharge planning. This article examines the trends within case management that has resulted in an imbalance of the functions of utilization review and discharge planning, and makes recommendations on how to rebalance these coexisting functions.
Birmingham
Jackie
J
Professional Services for Curaspan, Inc/e Discharge. jbirmingham@curaspan.com
D019090:Case Management; D033161:Government Regulation; D006801:Humans; D009732:Nursing Care; D010351:Patient Discharge / Q000592:standards*; D014481:United States; D014600:Utilization Review