Advancing Case Management’s Health Equity Pillars for Serious Illness (HEP-SI)

Presented by

Dr. Ellen Fink-Samnick
DBH, MSW, LCSW, ACSW, CCM, CCTP, FCM
Health equity is an integral factor of any quality healthcare equation. This theme is equally powerful in the end-of-life, or serious illness space. Timely palliative and hospice referrals are delayed by ongoing misconceptions of their intent by patients and practitioners. Cultural competence impacts ethical conversations by case managers about patient autonomy, prognosis, and quality of life. Implicit biases impede effective pain management across ethnicity, gender, and race, among other groups. Further barriers to care access for minoritized and marginalized populations are amplified by their lack of access to clinical trials, which adds another obstacle to advancing appropriate care. ‘Patient-centric care’ is no longer enough. Every patient and family should feel safe, seen, heard, and valued, and through every touchpoint of care. Yet, achieving this reality is case management’s latest challenge.

Learn how Case Management’s Health Equity Pillars for Serious Illness (HEP-SI) fuse clinical guidelines, accreditation and other regulatory requirements to expand your practice. Ensure ethical and compliance balance amid the ongoing health equity evolution. Advance your practice approach from “Patient-centric” to “Patient-inclusive”.
Behavioral Learning Objectives:

Attendees of this presentation will be able to:

1. Explore the intersections between health equity, social determinants of health, and serious illness.   

2. Apply case management’s Health Equity Pillars for Serious Illness (HEP-SI) to their practice population.

3. Cite case management’s established resources of guidance (e.g., professional regulations, accreditation standards, clinical guidelines, standards of practice, ethical codes). 

Dr. Ellen Fink-Samnick is an award-winning industry entrepreneur who empowers healthcare's interprofessional workforce. She is known as Professional Case Management’s Ethical Compass, and for her work in Health Equity, Integrated Care, Interprofessional Teams, Professional Case Management, Quality, and Trauma-informed Leadership. Dr. Fink-Samnick is the author of 5 books, including her recent publicationThe Ethical Case Manager: Tools and Tactics. Her 6th title, Behavioral Health for Case Management, will be published by the Case Management Institute and Blue Bayou press in January 2025. She is also editing her first book, Integrated Behavioral Health: Applying the Biodyne Model in Healthcare, to be published by Routledge in January 2026.

Dr. Fink-Samnick has a Doctorate in Behavioral Health with specialization in Health Equity, Integrated Care, Quality, Leadership, and Trauma-Informed Practice. She is a Licensed Clinical Social Worker, Board-certified Case Manager, and Certified Clinical Trauma Professional. Dr. Fink-Samnick is a Fellow in Case Management through the Case Management Society of America, a Fellow for RISE Association, and member of the academic honor society, Delta Epsilon Tau.

Dr. Fink-Samnick serves the industry through assorted roles with academic appointments at Cummings Graduate Institute of Behavioral Health Studies and George Mason University’s College of Public Health. Dr. Fink-Samnick is moderator of Ellen’s Ethical Lens on LinkedIn and author of the blog, Ellen’s Interprofessional Insights. She is a consultant for the Case Management Institute and a moderator for their Case Managers Community. Dr. Fink-Samnick is Editor of the Heartbeat of Case Management Column for Wolters Kluwer’s Professional Case Management Journal, and member of the journal’s editorial advisory board. ​

Dr. Fink-Samnick is known for her fierce professional voice. Along with leadership and committee roles across credentialing entities and professional associations, she has shared her expertise withAHIMA’s Data for Better Health Initiative, The Gravity Project, the Coalition for Social Work and Health, and RISE Association. Dr. Fink-Samnick currently serves on the national board of directors for the National Transitions of Care Coalition and is current Vice-Chair of CMSA’s Diversity, Equity, Inclusion, and Belonging Core Committee. Further information is available on her LinkedIn Profile.

"Supporting Nutrition Through Transitions of CareMedical Nutrition Therapy (MNT)"*

Presented by Carly Léon
Director of Healthcare Policy and Payment 
Academy of Nutrition and Dietetics

 Register   Here
                             

SUMMARY: Supporting Nutrition Through Transitions of Care Medical Nutrition Therapy (MNT) is an evidence-based, patient-centered service provided by Registered Dietitian Nutritionists (RDNs) that is often delivered over multiple sessions to manage nutrition-related conditions and improve health outcomes. As patients transition between care settings—whether from one facility to another or from a facility to home—ensuring the continuity of the nutrition care plan and ongoing access to MNT is critical. This is especially true during acute and subacute care discharge, where patients should be referred to MNT services to maintain consistency in care. Unfortunately, many patients and caregivers struggle to understand their health benefits and the importance of MNT. Care management plays a vital role in facilitating referrals and coordinating transitions. Starting in 2025, a new care pathway will streamline this process—ensuring patients and caregivers can fully utilize MNT services.

 LEARNING OBJECTIVES:

1. Understand the Definition and Application of Medical 
    Nutrition Therapy (MNT)

2. Enhance Patient and Caregiver Awareness about MNT
    and Payer Benefits

3. Support the Continuity of Nutrition Care Throughout
    Transitions of Care

SPEAKER BIO: Carly Léon is the Director of Healthcare Policy and Payment for the Academy of Nutrition and Dietetics. In this role, she collaborates with both government-funded and private payers to address issues impacting access and payment for services provided by registered dietitian nutritionists. Ensuring equitable access to nutrition services provided by qualified practitioners is central to her work. Carly leads efforts to increase the utilization of medical nutrition therapy throughout the U.S. health system, with a focus on integrating nutrition into value-based care. She also supports the Academy’s work with the American Medical Association’s CPT® code development and valuation processes.

Throughout her career, Carly has been involved in various advocacy and payment-related initiatives. She is excited to collaborate with like-minded colleagues as part of the Accountable Care Action Collaborative. Carly holds a Master of Science degree from Eastern Illinois University and a Bachelor of Science, Summa Cum Laude, in Nutrition and Dietetics from Loyola University Chicago. 

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.
 
 The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
 ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1 contact hour through the Florida Board of Nursing, Provider # 50-94.

August 14, 2024
AT 12:00 PM CT/1:00 PM ET
LUNCH N' LEARN WEBINAR:

"Transitions of Care Is
A Team Sport"*

Presented by
Cheri Lattimer, BSN
Executive Director, NTOCC                                               

  Register   Here
                          
Summary: 

Successful transition of care is built on the concept of a collaborative care team at every level of care.  Dr. Eric Coleman has often alluded to the fact that “transitions of care is a team sport.”  Knowing what the traits of a successful team culture should be helps us understand the focus and importance of building successful care teams. It also means opening up the communication channels not only between the all the providers of care but to include the patient and family caregiver as well.  When you have the care team defined does everyone know their role and the role of others?  Do we know how to communicate clearly, how to address different points of view and how to handle conflict?  Did we throw our collaborative care team together quickly or really assess, evaluate and embraced change when current roles and functions were not working?  This session will look at how we can address these concerns.

    Register   Here

 Objectives:

1. Define the traits associated with a successful team culture

2. Compare the playing fields of team sports to the playing field of healthcare

3. Identify who’s on the care team and their roles and responsibilities related to transitions

4. Discuss a transitions of care playlist/checklist.

.

Bio:

Cheri Lattimer, RN, BSN, serves as the Executive Director for the National Transitions of Care Coalition (NTOCC) and President/CEO of Integrity Advocacy & Management. Her leadership in quality improvement, case management, integrated health care, care coordination, and transitions of care is known on the national and international landscape. She is affiliated with various professional organizations and maintains active roles on several national boards and committees including URAC’s Health Standards Committee and URAC’s Health Equity Council, CMS Caregiver Workgroup, ABQAURP Board of Directors and ABQAURP CME Committee, Alliance for Health Innovation and the engAGE with HEART Project.

*This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1 contact hour through the Florida Board of Nursing, Provider # 50-94.

JOIN NTOCC
April 10, 2024
AT 12 PM CT/1PM ET
FOR 
THE NEXT NTOCC
LUNCH N' LEARN WEBINAR:
 

"Transition of Care in Clinical Trials"*

Presented by

Lee Holland, PharmD, MPH
Laura Shepprd, MBA, MA

Register Here

Summary: 
Despite extensive regulations controlling the conduction and oversight of clinical trials there are no requirements or guidelines concerning transitions of care for patients entering or leaving clinical trials. Currently, clinical trials participants face a wide variety of post-trial options. These range from no transitions of care support to open-label extension programs that continue to provide treatment.

This session will identify the gaps, barriers and concerns for patients and their family caregivers who volunteer to enroll in clinical trials. Our presenters assess issues for improving communication between clinical researchers and the standard of care providers. Please join us for this presentation and discussion forum on improving transitions for patients and their family caregivers involved in a clinical trial.

 

                      Register Here

Presenter(s) Bio: 

Lee Holland, PharmD, MPH
Dr. Lee Holland is the Associate Director, Plain Language Summaries at Certara. She has overseen the drafting of over 250 plain language documents, including summaries, protocol synopsis, clinicaltrials.gov Brief Title and Descriptions, and handouts explaining conference posters in plain language. Lee has also been a patient and caregiver advocate for almost 20 years. She has assisted many patients in accessing healthcare and other needed resources.

During the first two years of the COVID-19 pandemic, she volunteered in a Facebook group to provide her community with accurate information. During this work, she answered questions directly from the public on vaccines, clinical research, and COVID prevention measures. Lee brings her passion for patient advocacy to her work in plain language to educate and empower patients, caregivers, and their families. By combining health literacy expertise with clinical knowledge, she strives to be a voice for the overlooked and forgotten in our healthcare system. Prior to joining Certara, Lee was the Inaugural Research Fellow at Pharmacy Quality Alliance (PQA) in Alexandria, Virginia. While at PQA, Lee was involved in research into patient access to medication and healthcare quality.
______________________________________________________________________
Laura Sheppard, MBA, MA
Ms. Sheppard is the Senior Director, Regulatory Services Management and Lay Summary Team Lead and medical writer with experience in document quality control,
project management, and clinical transparency and disclosure in both contract research organizations and pharmaceutical environments. She has 20 years of experience in translational science, clinical development, and clinical operations, including 15 years in medical writing, document quality review, and regulatory strategy experience with global marketing applications for both biologics and small molecules, as well as for Investigational New Drug (IND), Marketing Authorization Applications (MAA) and Clinical Trial Authorization (CTA) applications.

Ms. Sheppard served her three consecutive terms with the American Medical Writers Association (AMWA) asa Director-At-Large. She supports her local AMWA chapter as the NJ Program Chair. Her experience in therapeutic areas includes anti-infectives, cardiovascular, central nervous system, endocrinology, gastrointestinal, immunology, nephrology, neurosciences,  oncology, pain management, rare disease, respiratory, urology, and xenotransplantation.

*This webinar does not provide CME/CE's.

JOIN NTOCC
May 23, 2023
 AT 12 PM CT/1PM ET
FOR 
THE NEXT NTOCC
LUNCH N' LEARN WEBINAR:

" A Script for Filling the Gap:
How Pharmacists Can Help
Patients During Transitions of Care" *

 Register Here

Presented by:

Dr Mary Lomberk
Mary Lomberk, PharmD, BCACP, CPh

Summary:

Medication management is a critical area during a patient’s care transition. Pharmacists are well positioned to offer assistance in this space as medication experts but are often underutilized. This course will look at the various ways pharmacists can be a supportive member of a patient’s health care team during transitions of care and help meet today’s healthcare issues around transitions. The Know Your Transitions of Care Pharmacist is a resource for patients, family and caregivers to bring additional information on how pharmacists can help. The resource includes relevant questions to ask your pharmacist and how a pharmacist is an advocate for your health. 

Objectives:
*Review the complexity of transitions of care

*Discuss the importance of medication management
within a patient’s care continuum

*Describe the various roles pharmacists
can play in transitions of care

*Assess the implementation of the patient
and caregiver education material
“Know Your Transitions of Care Pharmacist”

Presenter Bio:
Dr Lomberk is a Transitions of Care clinical pharmacist with Baycare Health System in Tampa Florida. Dr Lomberk is a graduate of Wingate University School of Pharmacy and completed her PGY1 residency training at Novant Health in Winston Salem, NC focusing in ambulatory care and population health. She is a board-certified ambulatory care pharmacist and consultant pharmacist who has helped develop and expand the transitions of care program and ambulatory care pharmacy presence within Baycare from 6 pharmacists to over 30 pharmacists since joining the health system in 2016. In her current role, Dr Lomberk provides continuity of care for hospitalized patients by working with an interdisciplinary team to resolve medication errors, promote patient education and reduce hospital readmissions. Dr Lomberk was recognized at the 2019 Baycare’s Quality Sharing Day for a remarkable patient story and has been a guest speaker for Baycare’s HealthChat Podcast. She also serves as a Pharmacist Advisory Committee member for the National Transitions of Care Coalition and Board member for Florida’s Association for Medication Education. She has a passion for mentoring and precepts students and residents as well and serves as a University of Florida mentor and resident research advisor. 

 
* This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.
 
 The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.
 
 ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

 

REGISTER HERE

THE NEXT NTOCC
LUNCH N' LEARN WEBINAR

"A Virtual Tutorial of the Updated NTOCC Compendium"
by
Cheri Lattimer
Dr. Edward Davidson
Lisa Han

MARCH 29, 2023
12PM CT/1PM ET

REGISTER HERE

JOIN NTOCC ON
OCTOBER 13, 2022
AT 12 PM CDT
FOR
THE NEXT NTOCC
LUNCH N' LEARN WEBINAR:

"REFRAMING HEALTHCARE THROUGH THE LENS OF AN AGING SOCIETY" 

REGISTER HERE

PRESENTED BY:

Michael Hodin, PhD 

CEO, Global Coalition on Aging 
Managing Partner, High Lantern Group 

  SUMMARY :

As populations around the world age as a result of increased longevity, health systems must adapt or face the grave consequences of failing to prepare for an older population with different care needs. Supporting innovation and rethinking current approaches to life course, care, and treatment are essential to ensure access to healthy aging for all.

SESSION LEARNING OBJECTIVES:

1. Address the gaps and barriers with the current healthcare system in addressing the needs of older populations

2. Assess necessary changes for transformational innovation in addressing the changing population needs

3. Define what steps are necessary for transitions and care coordination for healthy aging

SPEAKER BIO:

Michael W. Hodin, Ph.D. is CEO of the Global Coalition on Aging, Managing Partner at High Lantern Group, and a Fellow at Oxford University’s Harris Manchester College. He has spoken internationally on the topic of aging, including at G20, APEC, Davos, and the World Knowledge Forum (WKF). He is also a blogger on Medium. 
 

From 1976-80, Mike was Legislative Assistant to Senator Daniel Patrick Moynihan. During this period he was also a Visiting Scholar at Brookings Institution, on U.S. Foreign Economic Policy. He was a senior executive at Pfizer, Inc. for 30 years, where he created and then led its International Public Affairs and Public Policy operations and served on Management Boards for a number of its businesses. 

Mike is a Member of the Council on Foreign Relations, and from 2010-2013, was Adjunct Senior Fellow with a focus on population aging. Mike was also the recipient of the 2012 Fred D. Thompson Award from the American Federation for Aging Research. He sits on the Boards of the Foreign Policy Association, Business Council for International Understanding, American Skin Association, American Federation for Aging Research and Emigrant Savings Bank. Mike was a member of the World Economic Forum’s Global Agenda Council on Ageing. And he sits on the Advisory Board for the Milken Institute Center for the Future of Aging. 

Mike holds a BA, cum laude, Cornell University, M.Sc.in International Relations from The London School of Economics and Political Science, and M.Phil and Ph.D. in Political Science from Columbia University. 

Twitter: @mwhodin  

LinkedIn: https://www.linkedin.com/in/hodin/  

 This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical
Education through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and National Transitions of
Care Coalition (NTOCC). ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credit™.
Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hour through the Florida Board of Nursing, Provider #
50-94.

REGISTER HERE

September 22, 2022
AT 12 PM CDT
NTOCC LUNCH N' LEARN WEBINAR:

"Advancing Health Equity Through Care Transitions"

Presented by:
Michael B. Garrett, MS, CCM, CVE, BCPA
 
Summary :
This session will provide attendees with information on key terms and concepts in diversity, equity, and inclusion (DEI). The attendees will learn about effective communication strategies in the care transition process to support diverse clients/patients. Also, the attendees will be given recommendations on specific interventions in coordinating care through the care transition process that can support diverse clients/patients.
 

Session Learning Objectives:
 
1. Explain key terms and concepts in diversity, equity, and inclusion (DEI)

2. Identify ways to accelerate your individual journey in incorporating DEI into care transitions practice

3. Deploy practical interventions in care transitions in working with diverse patients/clients

Speaker Bio:

Michael Garrett is a consultant with more than 30 years of progressively responsible experience in case management, utilization management, healthcare quality, and population health management services. More recently, he has also been involved in diversity, equity, and inclusion (DEI) in health and benefits. He currently serves on URAC’s health standards committee, and he is on the editorial board of the peer-reviewed medical journal Professional Case Management. He has served as an author, editor, and contributor on seven case/care management books as well as the author of numerous journal articles in the field of case/care management. He holds a Bachelor of Arts degree in psychology and religious studies from Gonzaga University, and a Master of Science degree from the University of Idaho in clinical psychology. He is board certified in case management, vocational evaluation, and patient advocacy.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

 ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

Join NTOCC
June 29, 2022
AT 12 PM CDT
FOR
LUNCH N' LEARN WEBINAR:
"Identifying the Role of the Transitions of Care Pharmacist"

Register Here

Presented By:
Sara Panella, PharmD, BCPS Manager of Pharmacy Ambulatory Care, Population Health and Transitions of Care Clinical Pharmacy Enterprise

Charles Page, PharmD, RPh

Summary: Medication-related adverse events (AEs) in general practice represent an important cause of morbidity and are thought to cause between 10% and 30% of all hospital admissions in older patients.(National Library of Medicine).  Part of the answer resolving this problem is better engagement of  pharmacists within the interdisciplinary care team in support of better transitions and care coordination.  Pharmacists have a significant role in working with providers, patients and their identified family caregiver.  Taking a medication assessment, incorporating those findings into a medication care plan and providing education and coordination is a commitment transitions of care pharmacists are making every day.  This presentation will discuss that role and discuss 10 key pharmacists’ principles developed by the NTOCC TOC Pharmacists Task Force that support a safer and more positive patient journey.

Objectives:

1. Review the gaps and barriers related to poor transitions of care specific to medication management

2. List the tasks related to Medication Management Services

3. Discuss the reimbursement issues for pharmacists related to transitions of care interventions

Speakers: Dr. Sara M. Panella, PharmD, BCPS is currently the Manager of Pharmacy Ambulatory Care, Population Health and Transitions of Care Clinical Pharmacy Services for Baptist Health Enterprise, Baptist Health South Florida, in Miami Lakes, Florida. Dr. Panella obtained her Doctor of Pharmacy from the Ernest Mario School of Pharmacy (EMSOP), Rutgers, The State University of New Jersey in 2008. After graduation, she completed a Pharmacy Practice Residency at Yale-New Haven Hospital followed by a PGY-2 Specialty Pharmacy Residency in Drug Information at Robert Wood Johns University Hospital/EMSOP.

She started her career in TOC at University of Maryland Medical Center in Baltimore, MD and has since developed TOC programs there as well as at Memorial Regional Hospital in Hollywood, FL. Dr. Panella has also held academic positions at EMSOP as a Clinical Assistant Professor and at Nova Southeastern University as an Assistant Professor, and has also been a previous Residency Program Director for a PGY-2 in Transitions of Care. 

Dr. Charles Page, PharmD, RPh has been the Director of Pharmacy at Geer Village Senior Living in Canaan, CT for 19 years.  Dr. Page obtained his BS in pharmacy from the University of Connecticut in 1993 and completed his Pharmacy Doctorate in 2001 at Creighton University.  

Dr. Page started his career in community pharmacy, then spent 4 years in home infusion pharmacy before landing in long term care.  His unique practice setting on the campus of an elder care community offers numerous opportunities for engagement with fellow staff in transitions of care for the patients he serves, and he sees this role as a good platform to spread the word about the importance of greater pharmacist involvement in care transitions.

Register Here

IN CASE YOU MISSED IT......

The recording is now availible from the ntocc ROUNDTABLE  TOWNHALL MEETING

The ON DEMAND VIDEO OF THIS EVENT CAN BE FOUND HERE:  “Prescription opioid misuse during transitions of care”
 May 18, 2022

Cheri Lattimer, RN, BSN, NTOCC Executive Director
John Parker - Senior Vice President of Communications for Healthcare Distribution Alliance (HDA),

Lynette Sappe-Watkins – PA Foundation Executive Director,
Hannah Fish. PharmD - Director, Strategic Initiatives at National Community Pharmacists Association (NCPA).

One of the significant issues facing healthcare providers today are the concerns regarding opioid prescribing, misuse and abuse.  NTOCC and Allied Against Opioid Abuse (AAoA) are partnering to provide an hour of discussion with a panel of healthcare leaders in this field sharing information, resources you can access and an open question period on how we can work together to meet the needs of the patient and their identified family caregiver in addressing this issue.  Please join us for this important interactive webinar and discussion.  If you have specific questions you would still like the panel to address please send them to valemmons@gmail.com  This program does not have CME/CE’s.

REGISTER HERE

Survivors of TBI and their families each process the occurrence of a TBI through 6 unique stages using “grief theory” as a framework. There are key factors in the rehabilitation and recovery process that impact their level of acceptance, coping, and adjustment following a TBI. Understanding these stages by professionals, families, and survivors can directly enhance the success of their rehabilitation program and assist in achieving maximized successful outcomes. The case manager’s role in assisting patients who have sustained TBI can be greatly enhanced through an understanding of these stages, as readiness of the survivor and family to engage and participate in the case management process is dependent on the current stage of acceptance and coping being experienced. The case manager, as the conduit of information and communication, is in the unique position to support the interdisciplinary team with a thorough understanding of the family and survivor’s stages in the rehabilitation and recovery process.

Presented by

Deborah Gutteridge, MS, CBIST,
Clinical Evaluator

Ms. Gutteridge currently functions in the capacity of Regional Manager of Marketing and Business Development for NeuroRestorative, a national organization providing multiple levels of post-acute supports and services for persons with Acquired Brain Injury. Ms. Gutteridge possesses a Master’s of Science Degree in Counseling Psychology and is a Certified Brain Injury Specialist Trainer. She has recently served 3 years as President of the Board of Directors of the Brain Injury Association of Kansas and Greater Kansas City. She has served in the capacities of Director, Secretary, and President for the Case Management Society of America-KC Chapter, and has held several positions on the National Board of Directors of the Case Management Society of America. She was CMSA’s 2014 recipient of the Award of Service Excellence and most recently served as the President of the CMSA Foundation. She has worked in the field of brain injury for over 30 years. She is in her 22nd year of service with NeuroRestorative, and is a regular presenter for both local and national venues.

NTOCC CALL TO ACTION!!

This year the National Transitions of Care Coalition (NTOCC) convened a special task force to review and provide recommendation/revision enhancements to the NTOCC Care Transition Bundle: 7 Essential Intervention Categories.  The Care Transitions Bundle was first developed and launched in 2011 to support individuals and organizations with essential interventions for improving transitions of care for providers, patients and their identified family caregiver.

We would like to invite providers, patients and caregivers to review the suggested revisions and provide comments or thoughts about the proposed changes. There are seven (7) individual sections to review and you do not have to review all 7 but it is encouraged. The public comment period will be open for 30 days, ending on December 31, 2021.  

Feel free to share this link with your colleagues, patients and caregivers or other organizations as everyone is encouraged to review and provide comments.  https://nowcomment.com/blogs/29631

Please follow the instructions below for the "Now Comment" platform, in order to begin the process of reviewing the NTOCC Care Transitions Bundle: Seven Essential Intervention Categories. 

Link to all 7 of the the care transition bundle documents:

https://nowcomment.com/blogs/296311

In order to include your comments on the proposed revisions to 2011 NTOCC Care Transitions Bundle 7 Essential Elements document, you must set up a new account , on the Now Comment platform, which will only take about 60 seconds.

NTOCC is looking forward to recieving your comments regarding the proposed revisions to the Care Transition Bundle: 7 Essential Intervention Categories. As always if you have any questions regarding this Press release, please contact me anytime by phone at (501)712-8686 or by emailing me at valemmons@gmail.com.

Kindest Regards,
Val Emmons
NTOCC, VP Communications & Govt. Affairs

REGISTER HERE

Presented by:

Rebecca Perez, MSN RN CCM – Sr. Manager of Education and Strategic Partnerships &

CMSA Foundation Executive Director

Case Management Society of America

Abstract

Care transitions are a priority for all health care stakeholders and much work has been done in recent years to develop processes, incentives, disincentives, and metrics to improve transitions and prevent readmissions. Much has been published about transition management, and organizations are very focused on the process, so why are readmissions still a concern.

Approaching a transition as part of a continuum of care rather than a focused episode is a strategy that has resulted in reduced readmissions. Engaging case/care management with the care transition team will demonstrate improved outcomes, and in many cases, improved quality of life. This presentation will demonstrate the value of case/care management when included as part of care transitions, especially for those with multiple chronic conditions.

Objectives

As a result of this program, the participant will:

1. Analyze the causes of readmission regardless of transition process.

2. Comprehend the integral role of case/care management support of a transition process.

3. Discover the value and return on investment of case/care manager supported transitions.

Bio

Rebecca is an experienced Registered Nurse with a Master’s Degree in Nursing, is a Certified Case Manager, and a member of the Gamma Omega Chapter of Sigma Theta Tau International Nursing Honor Society. She is the author of numerous professional articles, a co-author of CMSA’s Integrated Case Management: A manual for case managers by case managers, developer of the Integrated Case Management Training Program, and Maser Trainer. She recently joined Parthenon Management Group as the Senior Manager of Education and Strategic Partnerships for the Case Management Society of America.

PRESENTED BY:

ELLEN FINK-SAMNICK

MSW, ACSW, LCSW, CCM, CCTP, CHMIMP, CRP, DBH(S)

SEP 21, 2021

12:00 PM CDT

REGISTER HERE

Abstract:

Few topics are more intimate and ethically complex for case managers than engaging with patients around end of life processes. The importance of this issue has been highlighted by evolving issues, from legislation and reimbursement, to the latest dimensions of the COVID-19 pandemic. Organizational mandates intersect with professional ethical codes yielding a fresh generation of ethical dilemmas for case managers to reconcile.

Citing the latest industry literature, regulations, ethical codes, and practice guidelines this unique presentation will provide attendees a comprehensive view of the evolving end of life care landscape. Emphasis will also be on a template to guide assessment of, and intervention with end of life situations across the developmental life span

Behavioral Learning Objectives are:

1. Discuss four (4) issues to influence the evolution of end of life care

2. Identify legal documentation associated with care decision-making

3. Identify related cultural implications across populations

4. Explore the ethical implications of EOL care amid the COVID-19 pandemic

5. Discuss how end of life care can pose ethical pitfalls for case managers

6. Implement the Intergenerational Spectrum toward patient (family) engagement during EOL care

7. Align EOL care to case management’s professionals ethical standards of practice and codes

BIO:

Ellen Fink-Samnick MSW, ACSW, LCSW, CCM, CCTP, CHMIMP, CRP, DBH(s)

Ellen Fink-Samnick is an award-winning industry thought leader who empowers healthcare's transdisciplinary workforce. She is subject matter expert on the Social Determinants of Health and Mental Health, Workplace Bullying and Violence, Professional Ethics, Professional Case Management Practice, and Wholistic Case Management™.

Her latest books include, The Essential Guide to Interprofessional Ethics for

Healthcare Case Management, The Social Determinants of Health: Case Management's Next

Frontier, End of Life Care for Case Management, and upcoming Social Determinants of Mental

Health: Advancing Wholistic Practice Excellence. Ellen is a panelist for Monitor Mondays, plus

contributor to RAC Monitor and ICD 10 Monitor. She serves as moderator of Ellen’s Ethical

Lens TM on LinkedIn, consultant for the Case Management Institute and moderator of their Case

Managers Community. Ellen is also Lead for Rise Association’s Social Determinants of Health

Community.

Ellen is a Licensed Clinical Social Worker, Board-certified Case Manager, Certified Clinical

Trauma Professional, Certified Mental Health Integrative Medicine Provider, and Certified

Rehabilitation Provider. She is a subject matter expert for Western Governors University, lead

clinical supervision trainer for NASW of Virginia, and adjunct faculty for University of Buffalo’s

School of Social Work, and George Mason University’s Department of Social Work. Ellen is also

a Doctor in Behavioral Health candidate at Cummings Graduate Institute of Behavioral Health

Studies.

Ellen’s passion is evident across her varied roles as professional speaker, industry consultant,

educator, continuing education content developer, accreditation specialist, clinical social work

supervisor and professional mentor to the case management community. Her contributions

transverse the industry’s professional associations and credentialing organizations. A past

commissioner for the Commission for Case Manager Certification, and Chair of their Ethics and

Professional Conduct Committee, member of the Board of Directors for the Case Management

Society of America, Ellen serves on the editorial boards for the Professional Case Management

Journal, Case Management Monthly, and RAC Monitor. More detailed information is available on

her LinkedIn Profile.

REGISTER HERE

PRESENTED BY

MELISSA CARDINE, MSN, RN, BCPA

There is a rapidly growing demand by patients and their families for access to independent patient advocates. Navigating the complexities of the current healthcare system has only become more challenging with the global pandemic. Patients were not allowed to have a loved one with them during a most vulnerable time moving from one level of care to another. This presentation will talk about the role a patient advocate can have in improving transitions of care.

 Learning Objectives:

After our session, those in attendance will be able to:

1. Discuss why health advocacy is needed
2. Define the role and scope of practice for a patient advocate
3. Describe how a patient advocate can improve transitions of care

Bio:

Melissa Cardine has been a nurse for over 20 years. Her passion is advocacy. In October of 2015, after more than 15 years at the bedside Melissa took this passion and the ideas she developed in her master’s program and founded The Bridge RN Patient Advocates. She enjoys listening to patients, families, and caregivers along with collaborating with healthcare professionals. Melissa was selected to be a Board Member of the Patient Advocate Certification Board (PACB) in November 2019 and currently is the President. Her passion for advocacy is evident in her daily interactions with all those she meets. 

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Please join NTOCC at 12pm CDT/1pm EDT for an in depth overview on:

 Reclaiming the Time Between Visits:

Using Free Technology to Build Relationships, Efficacy, an Improve Outcomes
Presented by
Geri Lynn Baumblatt, MA, Chief Engagement Officer at Docola
Eran Kabakov, PT, CEO and Founder of Docola,

Abstract: 

Time with patients and families is always limited. Even when we use communication and health literacy best practices to educate patients and families, they still struggle to remember what to do and how to do it, so they can successfully transition to home or a new care setting. Research shows that leveraging the time before and after conversations through asynchronous care communication, like ePrescribing, patient education and resources, can improve understanding, self-efficacy, health outcomes, reduce readmissions, clinic and ER visits, length of stay. There are also benefits for clinicians and organizations such as: improved conversations and relationships, new insights, and operational efficiencies. And there are now free, high quality resources and platforms that make it easier than ever to prescribe knowledge and communicate care.

Objectives: 3-4 Learning Objectives 

1. Describe asynchronous care communication and e-prescribing information to patients and families (information therapy)

2. Explain the benefits of asynchronous communication for patients and families to improve care transitions

3. Describe how e-prescribing resources can help build relationships, create operational efficiencies, and improve the provider experience

BIO’s:

Geri Lynn Baumblatt, MA has worked in patient communication, education, and engagement for over 20 years. She created of a large library of multimedia resources at Emmi and partnered on research to understand how they impacted patient understanding, shared decision making, and improve outcomes. As Chief Engagement Officer at Docola she is creating a patient education content clearinghouse. She’s also the co-founder the Difference Collaborative, serves on the editorial board for the Journal of Patient Experience, on the Patient Experience Policy Forum, and writes a column on patient engagement on Healthcare IT Today. @GeriLynn @DiffCollab 

Eran Kabakov, PT is CEO and Founder of Docola, a care communication platform where providers can find and e-prescribe information to patients and build relationships. Eran has been a clinician for over 30 years, and is a volunteer at the Aurora Project, and a member the Society for Participatory Medicine. @docolainc

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

REGISTER HERE FOR APRIL 20

Presented by
James Lett, MD, NTOCC President
Cheri Lattimer, RN, BSN, NTOCC Executive Director

Abstract: The COVID-19 pandemic has brought about unprecedented challenges for healthcare providers and their patients, highlighting the need for smooth transitions and care coordination.  This session will look at the issues that the COVID-19 pandemic has presented to the healthcare community.  Using the newly developed COVID-19 Pathway the speakers will describe the pathway, tools and resources that enable multidisciplinary transitions of care across health care settings.  

Objectives:

1. Review the epidemiology of the COVID-19 virus 
2. Identify the critical gaps in care transitions and coordination of patients with COVID-19
3. Assess interprofessional strategies that support effective care coordination 
4. Define a comprehensive hospital transition plan that supports patient and family caregiver factors
5. Apply interprofessional strategies and resource for enhanced communication with patients and their family caregivers

Bio's:
Dr. James Lett II, MD is a geriatric medicine specialist in Rockville, MD and has been practicing for 42 years. He graduated from University of Kentucky, College Of Medicine in 1974 and specializes in geriatric medicine.  He has more than forty years of medical practice that has included office, hospital, sub-acute and long-term care settings, and been a nursing facility medical director for more than 20 years. Dr. Lett has long been active in medical organizations, having served as president of such organizations on local, state, and national levels including as President of AMDA. He has written and spoken for a number of years about various long-term care subjects and the care of frail elders.  He was a founding member of the National Transitions of Care Coalition and currently serves as the Coalition’s President.

Cheri Lattimer, RN, BSN, is Executive Director for the National Transitions of Care Coalition (NTOCC) and President/CEO of Integrity Advocacy & Management. Her leadership in quality improvement, case management, care coordination, and transitions of care is known on the national and international landscape. She is affiliated with various professional organizations and maintains active roles on several national boards and committees including URAC’s Health Standards Committee, CMS Caregiver Workgroup, CMS Advisory Committee for Education and Outreach, ACHIEVE, ABQAURP CME Committee, and American Nurses Association.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

REGISTER HERE FOR APRIL 6

REGISTER HERE

Summary: This presentation will present a multidisciplinary approach to transitions of care with an emphasis on incorporating the role of a pharmacist. The discussion will include assisting transitioning patients and residents from hospital to home, hospital to nursing facilities, and nursing facilities to the home. Medication changes are frequent within each setting and unfortunately, changes are often lost in transition. Pharmacists can provide a skill set that helps ensure an optimal medication regimen. The current pandemic has brought special challenges to identifying medication concerns and techniques to work in this environment will also be discussed.

Objectives:

1. Review a model for Transition of Care incorporated in one hospital system and its evolution over time.

2. Discuss the benefits of an interdisciplinary team including nurses, social workers, community health workers, dieticians, pharmacists, and pharmacy technicians in providing care through transitioning to different settings.

3. Describe intervention settings and benefits of each including telephonic, hospital visit, attend physician visit, and home visits.

4. List obstacles encountered in ensuring optimal medication management and ways to tackle such obstacles.

5. Detail challenges encountered with recent pandemic and tools and skills incorporated to ensure the optimal impact on patient care.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

BIO: Tricia resides in Frederick County, Maryland, and is currently employed with Frederick Regional Health System as a pharmacist with community physicians and other providers through the Frederick Integrated Health Network. She received her Bachelors of Science in Pharmacy and her Doctor of Pharmacy from Purdue University and is a Certified Geriatric Pharmacist as well as Certified Care Professional. Her experience includes many years working in the long term care environment as well as working in a federal funded community health center, retail and hospital practice.

*This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

CMS BI-MONTHLY FORUM; HEAR IMPORTANT

UPDATES TO CMS QUALITY PROGRAMS

The Centers for Medicare & Medicaid Services (CMS) Quality Programs Bi-Monthly Forum will be held on Tuesday, January 26, from 2:30 – 3:30 p.m. ET. During this webinar, attendees will learn important updates relevant to CMS’s Quality Measurement and Value-Based Incentives Group (QMVIG). The forum will also provide stakeholders with the opportunity to ask CMS subject matter experts questions on quality reporting programs and initiatives that directly impact their organizations.

This forum will include the following topics:

• Medicare Promoting Interoperability Program Updates

• CMS QRDA I and III Implementation Guide Updates

• eCQI Resource Center Improvements

• Quality Payment Program Updates

• Care Compare Updates

Participation Information

Please use the link below to register for the January 26 forum. You will not be able to share your participant information because it will be unique to you. Please check your spam filter if you do not receive an email confirmation. You can also use the link below to share this event with your colleagues.                               

• Registration URL: https://register.gotowebinar.com/register/7277077437102865936

• Webinar ID: 803-908-283

Please note that registration for this webinar is limited, but the forum’s slide deck will be posted to the Promoting Interoperability Events webpage in the weeks following the webinar.

For More Information

If you have questions regarding registration, know of others who would like to be included in future communications regarding the forum, or prefer not to receive these communications, please email CMSQualityTeam@ketchum.com.

The Quality Measurement and Value-Based Incentives Group (QMVIG) is part of the CMS Center for Clinical Standards and Quality. QMVIG brings you programs on meaningful measure development, health information technology, quality compare programs (etc.).

Join CMS on January 21st for the CHART Model Community Transformation Track Payment Webinar

The Centers for Medicare & Medicaid Services (CMS) will host a webinar on January 21, 2021 to provide an overview of the Community Health Access and Rural Transformation (CHART) Model Community Transformation Track payment policies.

The CHART Model Community Transformation Track will test whether upfront investments, predictable capitated payments, and operational and regulatory flexibilities will enable rural health care providers to improve access to high quality care while reducing health care costs.

During the session, the CHART Model team will discuss the Community Transformation Track payment policies and provide additional guidance on how payments are calculated throughout the duration of the model. The forum will also provide an opportunity for attendees to ask the CHART Model team questions regarding these topics.

Session information and registration link are included below. Please feel free to submit questions in advance to our team using the field at the end of the registration form or by emailing CHARTModel@cms.hhs.gov

CHART Payment Webinar:

Thursday, January 21, 3:00-4:30pm ET

Register to attend here:

https://deloitte.zoom.us/webinar/register/WN_KhEZumzWTaOG92cMFkHubg

Feel free to forward this event to colleagues who may be interested in learning more about the CHART Model. Following the events, presentation materials will be available on the CHART Model webpage (https://innovation.cms.gov/innovation-models/chart-model).

You may contact the CHART Help Desk at CHARTModel@cms.hhs.gov with questions. To stay up to date on upcoming model announcements, events, and resources, join our CHART Listserv by visiting the CHART Model webpage at https://innovation.cms.gov/innovation-models/chart-model.

Centers for Medicare & Medicaid Services (CMS) has sent this update. To contact Centers for Medicare & Medicaid Services (CMS) go to our contact us page.

Please join NTOCC at 11am CDT/12pm EDT for an in depth overview on:

"Grief & Grit: Leadership in Turbulent Times"

Presented by
Melanie A. Prince, USAF, Colonel, retired
MSS, MSN, BSN, NE-BC, CCM
President, CMSA 2020 - 2022

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

Abstract:The year 2020 has brought unprecedented chaos to organizations and practice settings.  Leaders must lead in the face of personal and professional losses as the world copes with a historical pandemic.  

This session will discuss attributes leaders must exploit in order to be effective in achieving organizational goals.
Melanie A. Prince, is the President of Case Management Society of America (CMSA).  She served 30 years in the armed services, retiring in the rank of Colonel assigned to Headquarters Air Force where she was responsible for developing strategies to eliminate interpersonal violence in the military and advanced the Air Force Surgeon General’s global health care strategy.  She is also President, Care Associates Consulting specializing in case management program development and education.

Melanie is a certified case manager and medical-surgical nurse with over 30 years of progressive leadership responsibilities and diverse clinical experiences in emergency medicine, inpatient care, disaster management, ambulatory health, population health and medical management. 

Her excitement and confidence in the principles of case management led to the inauguration of the Air Force’s first independent Nurse Managed Clinic staffed exclusively by nurse case managers, where patient outcomes were game-changers for medical management and population health.  

Recognized for fusing business acumen with clinical expertise to launch award-winning programs, Melanie is considered a subject matter expert in case, disease, utilization management and LEAN strategy management. Melanie is a graduate of Air University in Montgomery, Alabama, where she earned a Master’s Degree in Military Strategic Studies.  She also has a Master’s Degree in Nursing with a concentration in Case Management from University of Arizona, and a Bachelor’s Degree in Nursing from University of Louisiana, Lafayette.   Melanie served as Adjunct Professor, Trinity Washington University teaching courses in Health Assessment, Disaster Preparedness for Nurses, and Health Care Leadership.

Active in professional organizations, Melanie has been elected to local and national leadership positions, as well as appointed to national advisory roles for the CMSA, including Chapter President and Treasurer, National Board Director, Secretary, Public Policy Committee and Case Management Industry Leadership Coalition member, Military Liaison and Advisor to the CMSA National Board.  As one of the founders of the DOD/Veterans Affairs Military Day, Melanie launched a forum that brought clinical case managers from diverse backgrounds who served wounded warriors and other clients, into a full day of workshops, collaborations, and professional development. 

Melanie has been a frequently requested speaker, including annual CMSA conferences, and penned case management content, editorials, policy, and training in various publications for both military and civilian audiences.  A distinguished leader and mentor in her profession, she has won numerous awards including the distinguished CMSA Chapter, 2003, National Case Manager of the Year, 2004 and various military decorations, including Defense Meritorious and Legion of Medal awards.

 REGISTER HERE 

ALSO ......Don’t forget to check the website
for other upcoming webinars and events.

REGISTER NOW FOR
NTOCC’s
TOWN HALL MEETING
October 28, 2020
4pm CST/ 5pm EST

"It is no secret that the COVID-19 pandemic has significantly impacted and changed our health care.  Transitions of care during this time continues to focus on how to help our patients, beneficiaries, residents and clients succeed at home in management of their health care concerns.  

Join us October 28th at our Virtual Town Hall Discussion to hear from health care experts about the issues and concerns they see in working with patients during this trying time. 

Then ask your questions of the panel in addressing your specific concerns.  Working together we can make a change and a safer journey for the populations we serve.  We hope you can join us. 

Send your questions in advance of the Town Hall Discussion to valemmons@gmail.com 

REGISTER HERE

Meet our Panelist:  

H. Edward Davidson, PharmD, MPH
Partner, Insight Therapeutics, LLC
Norfolk, VA

James E Lett, II, M.D., CMD-R
Medical Director,  Avar Consulting,  Inc. 
Rockville,  Maryland 

Jacqueline Vance, RNC, BSN, CDONA/LTC, FACDONA, IP-BC,ASCOM, CDP, LBBP Senior Director of Clinical Innovation and Education,
Mission Health Communities, LLC

Moderator:

Cheri Lattimer, RN, BSN
Executive Director NTOCC

Speaker: Mary McLaughlin Davis, DNP, ACNS-BC, NEA-BC, CCM.

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

The Case Management Society of America (CMSA) introduced a White Paper in 2019, which weighed prevalent models of Hospital Case Management against the goals and expectations of our rapidly evolving hospital environment. The various legacy models did not meet the standards of today’s health care environment.

The current Covid-19 Pandemic was a catalyst for many acute care hospitals, already contemplating changes to their Case Management Departments to forge ahead and plan how they can transform the theory of Hospital Case Management change into practice. The presentation will review the CMSA case for change and a hospital systems’ steps to implement the process.

Objectives:

Describe the key elements of a patient centered plan of care.

List the reasons that change is necessary during a pandemic

Identify the Principles and the CMSA Standards Practice that guide the change.

Biography:

Dr. Mary McLaughlin Davis became a certified care manager in 1993. She has provided care coordination services for inpatients, outpatients, and health care plans.

As a Clinical Nurse Specialist, Dr. McLaughlin Davis has worked extensively with patients having chronic disease, notably congestive heart failure and stroke. She is a Senior Director of Care Management for the Cleveland Clinic and a guest lecturer at Ursuline College.

Dr. McLaughlin Davis served as the national president for the Case Management Society of America (CMSA). She is involved with The Public Policy Committee for CMSA and for the Nursing Institute at the Cleveland Clinic. She speaks on care coordination topics across the country. She has written numerous articles about care coordination and published the Case Management Guide to Population Health through HCPro. Dr. McLaughlin Davis released, The Practice of Hospital Case Management: A White Paper through CMSA.

AUGUST 20, 2020
12pm CST/1pm EST 

REGISTER HERE

Assessing SODH and Improving Care Coordination 
Presented by
Ellen Fink-Samnick, MSA, ACSW, LCSW, CCM, CRP EFS
Supervision Strategies LLC

May 27, 2020
12pm CST/1pm EST

REGISTER HERE

Integrated Population Health Strategy 

Presented by
Debbie Welles’s-Powell,
Chief Population Health Officer, Essentia Health  

Summary: We will explore the importance of developing a strong population health strategy at the intersection of value-based care and community health. We know that social determinants of health and one’s social needs are significant indicators of an individual’s health as well as the community’s health outcomes; as such, we must work in tandem with our communities to bridge the gap between clinical care and community services. In order to truly deliver sustainable, population health, we must take a holistic approach, both delivering exceptional clinical care and connecting the populations we serve to the critical, nonclinical services they need.

OBJECTIVES INCLUDE: Unify Clinical and Financial Incentives of Value-Based Payment Models through an Integrated Population Health Strategy Assess how to allocate resources to different value-based payment models under a consolidated population health strategy Improve internal clinical engagement and establish external partnerships to succeed in population health initiatives Integrating Social Determinants of Health for better patient and community outcomes.

 This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.
When signing in (or creating a new account), on the ABQAURP website please make sure Membership Details are up-to-date. Most importantly, the Profession (CME/CE Certificate Type) or users may not be able to access the verification. Current accounts will receive a Redirect Error message if this is an issue with their account. The error MUST be resolved to allow access.

April 22,2020
12pm CST/1pm EST

REGISTER HERE

Aging Life Care Support Improving Coordination for Patients
Presented by
C. Taney Hamill, CEO, Aging Life Care Association® &

Liz Barlowe, President Aging Life Care Association®

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.

March 25, 2020
12pm CST/1pm EST

REGISTER HERE

Improving Healthcare Coordination through Technology
Presented by:
Fahad Rahman, CEO/Founder Lumihealth &
Yvonne Moyer, Co-Founder & COO Lumihealth

Summary:
Challenged to articulate the value of your care coordination efforts? Learn how to use technology to enhance care coordination efforts and measure ROI. Improve patient outcomes and care
effectiveness through workflows that support actionable and impactful care delivery.

Webinar Learning Objectives:
1. Implement care management technology/workflow focused on
actionable care delivery
2. Develop methodologies to learn which tasks/interventions are
impactful in care delivery
3. Calculate technology return on investment (ROI) based on
scalability, efficiency, and impact

 This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the American Board of Quality Assurance and Utilization Review Physicians, Inc. (ABQAURP) and the National Transitions of Care Coalition (NTOCC).  ABQAURP is accredited by the ACCME to provide continuing medical education for physicians.

The American Board of Quality Assurance and Utilization Review Physicians, Inc. designates this live activity for a maximum of 1.0 AMA PRA Category 1 Credits™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABQAURP is an approved provider of continuing education for nurses. This activity is designated for 1.0 contact hours through the Florida Board of Nursing, Provider # 50-94.
When signing in (or creating a new account), on the ABQAURP website please make sure Membership Details are up-to-date. Most importantly, the Profession (CME/CE Certificate Type) or users may not be able to access the verification. Current accounts will receive a Redirect Error message if this is an issue with their account. The error MUST be resolved to allow access.