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CRMC To Receive Consulting For Streamlined Case Management

/ The Upper Cumberland's News Leader
CRMC To Receive Consulting For Streamlined Case Management

Cookeville Regional Medical Center will undergo consulting services from Clinical Intelligence to redesign and improve case management.

CEO Buffy Key said the consultants will put processes in place to help the hospital’s Case Management Department get patients out to continuums of care as soon as a patient is ready. Key said this would be a year-long process with the potential for reimbursement if the new processes do not prove effective.

“We’re very excited about this because they’re actually coming in and working with our processes,” Key said. “You know, 99.9 percent of the time, it’s not the people who are the issue, it’s our processes that we’ve developed over time, and we’re bigger. We’re busier. Our patients are sicker. So we need all of the new processes we can get.”

She said the nine-month implementation process will be followed by a three-month monitoring period. Clinical Intelligence has agreed to go at risk and refund a portion of the fee charged to the hospital if Cookeville Regional does not see a return on investment of at least $4.5 million.

“We’re just putting things in place, processes in place to help physicians to get these patients where they need to go as soon as they need to go,” Key said. “Not any quicker than they need to be. And then if we have good quality care, which is what this whole thing is, the best quality for the patient, the money takes care of itself.”

Key said Cookeville Regional is substantially federally funded by CMS, TennCare, and other insurance agencies. She said those agencies allow certain lengths of stay time for different disease states with a maximum revenue that changes based on the amount of time a patient remains under the hospital’s care. She said this consulting can help facilitate the safe and efficient transfer of patients to their next destination.

“Every single disease state that comes into the hospital that we take care of, of course, our business is taking care of that patient and getting them home or to their next continuum of care when it’s time to go,” Key said.

The CRMC Finance Committee will bring the proposed purchase to the Board of Trustees for approval on Thursday.


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