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In This Issue:
University of Chicago Medical Center
How can you help to ensure that CMSA’s leadership represents the collective voice of members, like you, throughout the health care industry and the nation?

Vote in CMSA's National Board Election!  One of the unique privileges you have as a member is to decide who serves on CMSA’s governing board.  Your participation in electing members to our National Board is absolutely crucial to ensure the ongoing growth and success of the nation’s oldest, not-for-profit organization representing the case management profession.

You’re a member with a voice — let’s hear it today!  Cast your vote by visiting and entering the personal registration code sent to you via email earlier this week.  Alternatively, click the auto login link in this week's email to connect directly, read the biographies, and vote.  Don't delay, as voting ends on March 12, 2012.
Integrated Care Management
CMSA's Annual Conference & Expo will be here before you know it!  Plan now to secure your spot for this week of education and networking in beautiful San Francisco.

Registration is OPEN at

This year's event is June 19-22, 2012 at the Moscone Center West in the "City by the Bay."  Our theme – "Spanning the Waves of Change in an Ocean of Opportunities" – underscores what an exciting time it is to be in health care, especially as a case management professional.

Register for the conference and reserve your accommodations today – CMSA and San Francisco await you!
Join us in Washington, D.C. on April 23-24, 2012

What is the latest information and activity on and around the Hill? CMSA members and case management professionals will find the answer to that question when they converge on the District of Columbia from all parts of the country on April 23-24, 2012.

Register today at

Attendees will receive important updates on legislative and policy related to case management and concerning national issues in health care reform. They will learn how to interact at the national level and how to apply this knowledge at the local level for greater impact. Attendees will visit "The Hill," where they will spend time with members of Congress, representatives from federal agencies, CMSA leaders, and other experts who will address attendees with the latest information.

This public policy summit was created to give CM professionals much needed tools and resources to advocate effectively for policies that impact case management, the effective delivery of health care, and – ultimately – that improve patients’ health and well being.
March 22-23, 2012
Orlando, Fla.

CMSA Member Discount: SAVE $300 when you register at 800-767-9499 by February 24 with PROMO CODE YGQ452 (discount not valid on government or previous registrations).

The World Congress Leadership Summit on Integrating Behavioral Health into Patient-Centered Primary Care and Medical Homes will bring together leaders and experts in policy, primary care, behavioral care and the payer communities to discuss what you need to do to integrate systems in a Medical Home, partner with your payer, engage patients, and to measure the effectiveness of redesigned care. Payment for integrated behavioral health care, a long time barrier to moving forward, will be tackled head on with viewpoints from the commercial and public payer sectors that are recognizing the value of these new programs and are paying for them.
Date: Thursday, Feb. 23, 2012
Time: 3 p.m. - 4 p.m. CST

Would you like to learn more about the 2012 Public Policy Summit? Register for this free webinar and discover the benefits and value of attending this year's Summit as well as how you can affect health policy at both the local and national levels.
Member Announcements
The Agency for Healthcare Research & Quality (AHRQ) welcomes the Case Management Society of America (CMSA) as the most recent national professional society to link to a continuing education (CE) website supported by AHRQ providing CE in patient-centered outcomes research, also known as comparative effectiveness research.

AHRQ is providing multimedia online CE modules for a wide audience of health care professionals across the health care continuum, including nurses in all practice settings and roles. The program is funded under the American Recovery and Reinvestment Act.
MedEscort International
Featured Article
By Pat Stricker, RN, M Ed
SVP of Clinical Services
TCS Healthcare Technologies

The advent of health IT (HIT) systems has transformed the health care industry. Leveraging technology to improve medical management intervention strategies should remain a high priority in terms of both improving patient outcomes and reducing medical costs. These applications are ever-evolving tools that support care management. Clearly, HIT applications are changing the practice of care management in profound ways.
Source: U.S. Department of Health and Human Services

People in the market for health insurance will soon have clear, understandable, and straightforward information on what health plans will cover, what limitations or conditions will apply, and what they will pay for services thanks to the Affordable Care Act – the health reform law – according to final regulations published today.
The new rules, published jointly by the Departments of Health and Human Services, Labor and Treasury require health insurers to eliminate technical or confusing language from their marketing materials that sometimes make it difficult for consumers to understand exactly what they are buying.  The new rules will also make it easier for people and employers to directly compare one plan to another.
"Consumers, for the first time, will really be able to clearly comprehend the sometimes confusing language insurance plans often use in marketing," said HHS Secretary Kathleen Sebelius. "This will give them a new edge in deciding which plan will best suit their needs and those of their families or employees."

Health plans and providers alike have been touting the benefits of incorporating "embedded nurses" or care coordinators into their ACO framework, reporting that they contribute to improved patient outcomes by providing a significant communication link between the patient and physician. In unveiling recent ACO ventures or achievements in both the Medicare and commercial space, insurers such as Aetna Inc. and Cigna Corp. have highlighted these caregivers as pivotal to the success of their accountable care models.

"It’s the care coordinator — in almost all cases a registered nurse — who uses the patient-specific data we send to our ACO physician practice partners for outreach calls and follow-up care," Cigna spokesperson Mark Slitt tells ABN.
Source: Centers for Medicare & Medicaid Services

Central line-associated bloodstream infections (CLABSIs) are among the most serious of all healthcare-associated infections, resulting in thousands of deaths each year and nearly $700 million in added costs to the U.S. healthcare system.  Today, the Centers for Medicare & Medicaid Services (CMS) announced that Hospital Compare will now include data about how often these preventable infections occur in hospital intensive care units across the country.  This step will hold hospitals accountable for bringing down these rates, saving thousands of lives and millions of dollars each year. 

"Including central line-associated bloodstream infections information on Hospital Compare will save lives and cut costs," said acting CMS Administrator Marilyn Tavenner.  "Adding this information to Hospital Compare extends the Administration’s commitment to make American healthcare safer."
Source: U.S. Department of Health and Human Services

Attorney General Eric Holder and Department of Health and Human Services (HHS) Secretary Kathleen Sebelius released a new report showing that the government’s health care fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayer dollars in Fiscal Year (FY) 2011.  This is the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers or who sought payments to which they were not entitled.  

These findings, released today, in the annual Health Care Fraud and Abuse Control Program (HCFAC) report, are a result of President Obama making the elimination of fraud, waste and abuse a top priority in his administration.  The success of this joint Department of Justice and HHS effort would not have been possible without the Health Care Fraud Prevention & Enforcement Action Team (HEAT), created in 2009 to prevent fraud, waste and abuse in the Medicare and Medicaid programs, and to crack down on the fraud perpetrators who are abusing the system and costing American taxpayers billions of dollars.  These efforts to reduce fraud will continue to improve with the new tools and resources provided by the Affordable Care Act.

With providers across the country experimenting with transitional care improvements, many models that are spearheading the movement share some common interventions, said Cheri Lattimer, executive director for the non-profit National Transitions of Care Coalition, in a keynote address at the World Congress 3rd Annual Leadership Summit on Hospital Readmissions on January 27.

Lattimer outlined several models at the Falls Church, Va., event, including transition coaching, advanced nurse practitioner participation, the use of a guided care nurse, Boston University's Project RED, and the Society of Hospital Medicine's Project Boost.

The best transitional care model is "not about the [individual] model; it's what they have in common," Lattimer said in a keynote address. The current models leading the national experiment all focus on a team approach to reengineer the entire discharge process.  In fact, she said she would like the term "discharge" to turn into a focus on "transition."

Source: U.S. Department of Health and Human Services

A new U.S. Department of Health and Human Services (HHS) report released yesterday shows 54 million Americans enrolled in a private health insurance plan have already received coverage of at least one new free preventive service as a result of the Affordable Care Act, while a companion HHS report estimates 32.5 million people in Medicare have taken advantage of at least one free preventive benefit – including the new Annual Wellness Visit – since the Affordable Care Act became law.

The Affordable Care Act requires many insurance plans to provide coverage without cost sharing to enrollees for certain preventive health services such as colonoscopy screening for colon cancer, Pap smears and mammograms for women, well-child visits, flu shots for all children and adults, and many more. The law also makes proven preventive services free for people in Original Medicare.

Industry Events
Wyndham Tampa Westshore
March 3, 2012 – 7:45 a.m. - 5:30 p.m.

CMSA Member Discounts:
Use code CMSAMBR to save $100 off registration
Use code CMSAEXAM to get a 10% discount on the exam

Prepare to become a leader in care quality at ABQAURP’s live conference on March 3rd.  A primer for the Health Care Quality and Management (HCQM) Certification Exam, "A Review of the Core Body of Knowledge" is a full day conference designed to provide attendees:

•    Select access to exam topics
•    Guidance directly from exam writers
•    Knowledge on essential health care quality topics
•    Focus on the path to earning the HCQM credential

HCQM certification demonstrates to internal and external entities that you, your group practice, or hospital is accountable. The result is a safer, more efficient, and cost-effective system that better satisfies the needs of patients, providers, purchasers, and payers.

Register today at
March 22-23, 2012
Orlando, Fla.

CMSA Member Discount: SAVE $300 when you register at 800-767-9499 by February 24 with PROMO CODE KYJ799 (discount not valid on government or previous registrations).

The 9th Annual World Congress Leadership Summit on Optimizing the Role of the Physician Advisor will focus on defining the expanding role of the physician advisor. New advisors can learn the basics of the position and all will benefit from the shared knowledge and networking capabilities of a national event.

Health Net
Select Medical
Restore Health Group
The Trizetto Group, Inc.
Naturs Design
Nurse Resolutions

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