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The Case Manager's Handbook, 6th Edition

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Catherine M. Mullahy, RN, BS, CRRN, CCM

This practical text helps case managers learn the fundamentals, study for the Certified Case Manager (CCM) exam, and advance their careers after the exam. Updated and enhanced with information on the latest developments affecting case management, The Case Manager's Handbook, Sixth Edition, reflects the rapidly changing healthcare landscape, including the significant effects of the Affordable Care Act (ACA).

New Chapters:
  • Workers' compensation case management
  • 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
  • Transformative healthcare approaches for the millenial generation
  • Key factors driving today's healthcare system
This item contains internet access codes. Returns are not accepted if seal is broken or access code revealed.
Table of Contents
Part I Introduction: Biography of a Case Manager
1 The Case Manager as Catalyst, Problem Solver, Educator
2 The Case Manager's Universe
II Part II: Case Management Process: The Microsystem Level
3 The Case Management Work Format and Process
APPENDIX 3-A VIII. Standards of Case Management Practice
4 Communications And Patient Engagement
Part III Practice Settings And Models of Care
5 Hospital Case Management: Changing Roles and Transitions of Care
6 ACOs, PCMHs, And State Health Exchanges
7 Independent Case Management
8 Home Care Case Management, Long-Term Care and Health Care Reform
9 Pediatric Case Management
10 Workers' Compensation Case Management
Part IV The Case Management Professional
11 Legal Responsibilities Of The Case Management Professional
APPENDIX 11-A Written Agreement: Some Typical Provisions
APPENDIX 11-B Legal Issues in Case Management Checklist
APPENDIX 11-C AMA Evidence-Based Principles of Discharge and Discharge Criteria
APPENDIX 11-D U.S. Legislation Review Relevant to Healthcare Case Management
12 Ethical Responsibilities Of The Case Management Professional
APPENDIX 12-A CCMC Rules of Conduct
APPENDIX 12-B Excerpts from the CCMC Code of Professional Conduct for Case Managers
13 Evidence-Based Practice For Case Managers: Data-Driven Decision Making
14 Case Manager Credentialing and Organizational Accreditation
Part V Reimbursement
15 Reimbursement Resources And Challenges
16 Healthcare Reimbursement: Private-Sector or Employer-Sector Funding
17 Healthcare Reimbursement: Public Sector
18 Working Effectively With Claims Departments: Case Managers In Consulting Roles
Part VI Leadership And Management: Macrosystems
19 Outcomes Management With Analysis Of Financial And Quality Assurance Reporting
APPENDIX 19-A Program Questionnaire and Facility Review for Case Managers
APPENDIX 19-B Provider Service Agreements
APPENDIX 19-C Expanded Cost–Benefit Analysis Summary
APPENDIX 19-D Expanded Cost–Benefit Analysis Summary for -Self-Funded Plan
20 New Strategies for Leading A Case Management Department: Today and Into the Future
APPENDIX 20-A Sample Nurse Reviewer for Prenotification Department Position Description
APPENDIX 20-B Sample Medical Case Manager Position Description
APPENDIX 20-C Sample Director of Case Management Services Position Description
21 Predictive Modeling And Case Stratification
Part VII Focus On Current Challenges And Emerging Trends
22 New Characteristics of Today's Healthcare Systems
23 The Case Manager's Role in the Era of Value-Based Healthcare
24 New Case Management and Healthcare Provider Approaches for Managing the High Risk, High Cost Patient
25 The Aging Population, Medical Advancements, And New Case Management Considerations
26 Dying In America
APPENDIX 26-A: End-of-Life Care: The Latino Culture
APPENDIX 26-B: End-of-Life Care: The Russian Culture
APPENDIX 26-C: End-of-Life Care: The Vietnamese Culture
27 Medication Management: A Case Management Call to Action
28 Pain Management
29 Our Nation's Multiculturalism And Challenges To Case Managers
APPENDIX 29-A: Communicating with Your Chinese Patient
APPENDIX 29-B: Communicating with Your American Indian/Alaska Native Patient
APPENDIX 29-C: Communicating with Your Latino Patient
APPENDIX 29-D: Communicating with Your Russian Patient
30 Health Literacy And Adherence Issues
31 Obesity: The New Epidemic
32 Behavioral Health with Primary Care: An Integrated Model of Care
33 Healthcare Technology And Trends: Implications For Case Managers
34 Transformative Healthcare Approaches for the Millennial Generation
35 The Affordable Care Act Of 2010: Implications For Case Managers
Publication Date 2016
Format Hardcover, 746 pages
Product Code 07069