Key Points:

  • Value-Based Purchasing
  • Efficiency Measure
  • Length of stay
  • Cost of Care
  • Care coordination

The CMS Efficiency Measure: Case Management Strategies for Managing Cost and Length of Stay


As one of the elements of health care reform, The Centers for Medicare and Medicaid Services (CMS) has implemented a course of action aimed at bringing Medicare to a break-even budget.  The elements that we are now familiar with include the ‘clinical processes of care’, ‘outcomes’ (which include readmissions, deaths and complications), ‘the patient experience of care’, and now the “efficiency measure”. The “Spending per Medicare Beneficiary Measure” or the ‘efficiency measure’ brings much of the work of case management to the surface yet again.  This measure focuses on length of stay and spending per a beneficiary episode, two elements that case management plays a critical role in controlling and managing. 

Medicare’s purpose in applying this measure is to encourage hospitals to be more cost efficient by providing financial incentives to hospitals based on their performance.  CMS also hopes to increase the transparency of care for consumers and recognize hospitals that are involved in providing high quality care at lower cost.

Session Highlights:
  • The Value-Based Purchasing domains
  • The definition and scoring used for the CMS Efficiency Measure
  • Care coordination’s impact on length of stay and cost
  • Five key elements of care coordination
  • Elements impacting on length of stay
  • Strategies for evaluating your hospital’s own areas of inefficiency
Why Should You Attend?
  • Learn your hospital’s own efficiency measure and what it means.
  • Discuss how to improve your length of stay and cost per case through better care coordination
  • Discuss how cost across the continuum affects your hospital’s cost per case.
  • Understand where your case management department may have the biggest impact on reducing your cost and length of stay.
Who Should Attend?

Director of Case Management, Case Managers, Directors of Nursing, Directors of Patient Flow, Director of Revenue Cycle, Chief Financial Officers, Chief Operations Officers, Chief Medical Officer, Hospitalists, Director of Quality Management, Nursing Home Directors, Director of Home Care


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