CMSA Today - Issue 7, 2016 - 30

"Advocacy is one of the Standards of Practice for case managers. (CMSA, CMSA's 2016 Standards of Practice for Case Management, rev. 2016). Case managers are needed to advocate at many levels: the patient level, the case managers' level, and the regulatory and legislative level." You know who you are (which is a story for another day). As I reflect now on the experience wearing my leadership hat, I can see how many opportunities there are for case managers/ care coordinators in our healthcare system today, more than I ever realized. And I thought I had a very good handle on what was going on in our field from an advocate's view looking at our nation's regulatory and legislative agenda and from a business perspective as vice president of medical management for MVP HealthCare, a managed care organization serving over 750,000 members in New York. This is a community-based organization which has won several awards and grants for its integrated case management programs. However, until I reversed my role and became the patient, I didn't realize how great the need was for case managers. The world NEEDS case managers! This tremendous need comes from providers, patients and their caregivers, and from payers. The diagnosticians need case managers to assist them in managing the patients' reactions to the diagnosis and the families' shock and apprehensions. The case managers are needed to coordinate all the steps in the process and to gather the much-needed data and resources to help both the family and the patient make informed, life-altering decisions quickly: which surgeon, which hospital, which treatment center will offer them the best and most convenient care, which oncologist should be engaged, is a second opinion needed, and if yes, how is that decision made? What will this all cost; will insurance cover everything? Is a leave of absence from work indicated, and what about disability insurance? Where do post-op care, home care, chemotherapy, lab work and port insertion surgery happen? The list goes on and on, and most people just shake their heads and say, "Where do I begin?" Well, I am here to tell you, you begin with getting a case manager. 30 CMSA TODAY Issue 7 * 2016 * DIGITAL There are a number of organizations out there that can help. However, the real opportunity is in your primary care provider's office, especially if he or she is the one who made the referral for the diagnostic tests which set the world shifting under your feet. Licensed healthcare professionals who understand the system, who know how to safely coordinate your transitions of care from setting to setting, ensuring a comprehensive, effective "warm hand off," can calm patients' fears, alleviate the families' anxiety and stress, can furnish answers and develop a comprehensive, patient-centered, integrated plan of care with input from all stakeholders are at a premium. Patients need case managers to be their voice. Even the most educated patients can become helpless, vulnerable and speechless at times like these. Advocacy is one of the Standards of Practice for case managers. (CMSA, CMSA's 2016 Standards of Practice for Case Management, rev. 2016). Case managers are needed to advocate at many levels: the patient level, the case managers' level, and the regulatory and legislative level. The opportunities for case managers have never been greater. Good case managers can do direct case management in different settings - hospitals, urgent care centers, ambulatory surgical suites, family health centers, home care, primary care offices, managed care organizations, and now in New York, Health Homes (a federally funded program). All members enrolled in Health Homes receive case management services. There are opportunities for hands-on case managers, telephonic work, administrative work, and government liaison work. The healthcare arena is open today as it has never been before for case managers. So be the best you can be; don't waste any time, and if you have been thinking about becoming a case manager, go to the CMSA website to learn more. If you are already a case manager, continue your education, become certified and get involved. As the need for us grows stronger and more and more people recognize the value of our services, we need to advocate for CMS to develop billing and reimbursement codes for our service. We also need to continue to design curricula to accommodate case managers at every level - baccalaureate, masters and doctorate, and strongly encourage certification. Dear fellow case manager, the sky is the limit for us in today's healthcare world. We are very fortunate to be at the epicenter of this wonderful and exciting time when case managers, providers, patients, caregivers and payers have begun to realize that together we can make a difference. Margaret Leonard, MS, RN-BC, FNP, is Sr. VP for Clinical Services at MVP. To reach out to Peggy, email her at margaretleonard012@gmail.com. WENDY DE VREUGD, RN, BSN, PHN, FNP, CCDS, MBA T he case manager competencies and traits necessary to support clientcentered and culturally appropriate care in practice are many: how to assess and evaluate, formulate a plan, encourage selfcare, negotiate, be persistent, communicate effectively, be culturally diverse and advocate for our patients - to name only a few. However, when a case manager lands on the "other side of the bedrails" due to a serious health challenge, she or he may experience that those same strengths you think you have can be temporarily lost; or even worse, one can revert to feeling like a complete neophyte in the "system" we think we all know so well. How does that happen? Experiencing a role

Table of Contents for the Digital Edition of CMSA Today - Issue 7, 2016

PRESIDENT’S LETTER
ASSOCIATION NEWS
CMSA CORPORATE PARTNERS
Are You Culturally Competent?
Return to Culture – Return to Healing
Appalachian Culture: A Guide for Case Managers
Professional Case Management’s Ethical Quartet for 2017: Part 1, Workplace Bullying and End of Life Care
Diversity of Role Reversal: When the Case Manager Becomes the Patient
INDEX OF ADVERTISERS
CMSA Today - Issue 7, 2016 - cover1
CMSA Today - Issue 7, 2016 - cover2
CMSA Today - Issue 7, 2016 - 3
CMSA Today - Issue 7, 2016 - 4
CMSA Today - Issue 7, 2016 - 5
CMSA Today - Issue 7, 2016 - PRESIDENT’S LETTER
CMSA Today - Issue 7, 2016 - 7
CMSA Today - Issue 7, 2016 - 8
CMSA Today - Issue 7, 2016 - 9
CMSA Today - Issue 7, 2016 - ASSOCIATION NEWS
CMSA Today - Issue 7, 2016 - 11
CMSA Today - Issue 7, 2016 - CMSA CORPORATE PARTNERS
CMSA Today - Issue 7, 2016 - 13
CMSA Today - Issue 7, 2016 - Are You Culturally Competent?
CMSA Today - Issue 7, 2016 - 15
CMSA Today - Issue 7, 2016 - Return to Culture – Return to Healing
CMSA Today - Issue 7, 2016 - 17
CMSA Today - Issue 7, 2016 - 18
CMSA Today - Issue 7, 2016 - 19
CMSA Today - Issue 7, 2016 - Appalachian Culture: A Guide for Case Managers
CMSA Today - Issue 7, 2016 - 21
CMSA Today - Issue 7, 2016 - 22
CMSA Today - Issue 7, 2016 - Professional Case Management’s Ethical Quartet for 2017: Part 1, Workplace Bullying and End of Life Care
CMSA Today - Issue 7, 2016 - 24
CMSA Today - Issue 7, 2016 - 25
CMSA Today - Issue 7, 2016 - 26
CMSA Today - Issue 7, 2016 - 27
CMSA Today - Issue 7, 2016 - Diversity of Role Reversal: When the Case Manager Becomes the Patient
CMSA Today - Issue 7, 2016 - 29
CMSA Today - Issue 7, 2016 - 30
CMSA Today - Issue 7, 2016 - 31
CMSA Today - Issue 7, 2016 - 32
CMSA Today - Issue 7, 2016 - 33
CMSA Today - Issue 7, 2016 - INDEX OF ADVERTISERS
CMSA Today - Issue 7, 2016 - cover3
CMSA Today - Issue 7, 2016 - cover4
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