Case Management Considerations: When Should You Consider Hospice Care?

Terminally ill fatherBy: Dominick L. Flarey, Ph.D, RN-BC, MBA, ANP-BC, FACHE

Executive Director
The American Academy of Case Management


Case Managers today are on the front lines of palliative care and hospice care. Such models of care are complex and require the management of patients with very holistic health care needs including physical, emotional and spiritual. Patients and families often find that making choices about entering a hospice care program are very difficult and often times very frightening. They realize that the patient’s prognosis is poor and that they are entering the final stages of life. Patients and families are generally entering a time of Anticipatory grieving. So many questions regarding hospice exist especially related to the type of care and support services that will be provided to both the patient and the family. Case Managers are in an excellent position to be solid advocates and managers for facilitating this entire process and support high quality and cost effective outcomes in hospice care.

Very often, the first step in the process for patients’ and families is determining when hospice care should be considered. Good hospice care programs focus on relieving, rather than curing, a terminal patient’s physical symptoms. Hospice also provides support for patients as they cope with the emotional and social facets of dying. There are several situations in which patients and families may contemplate using hospice care. It is important that case managers educate patients and families on the total array of services that hospice care provides. Many have the misconception that hospice care is for pain control only. This is the farthest from the truth, of course. Here the case manager may play a critically important role providing more detail as to the many services and benefits that are available such as coordination of physician services and communications, RN home visits and pain control, the availability of nursing assistants in the home, grief counseling services, coordination of clergy visits and spiritual counseling, as well as insurance benefits consulting.

Often, your health care provider will refer you or your family member to a hospice program. He or she will typically make the suggestion when the patient has a life expectancy of fewer than six months. Hospice care frequently takes place in the terminal patient’s home, but in appropriate circumstances can also be offered at hospitals, nursing homes, and dedicated hospice centers. Here case manager’s work closely with insurance companies and government payers to insure that the patient meets the necessary criteria for hospice care and that the care will be covered appropriately under the patients plan. Case managers having education and expertise in managed care can also help insure that he patient is getting all of the available resources provided in their insurance plans.

If your health care provider does not mention hospice or if you initially refuse the option, you may find yourself considering it at a later stage. For example, terminal patients whose families are caring for them at home may worry that they have become burdens. At the same time, family members may experience “compassion fatigue” and need some respite in order to recharge their own batteries. Hospice volunteers can provide this respite in the patient’s home or in another care setting.

Respite care is a wonderful hospice benefit and case managers can be real advocates for families when respite care is critically needed for the family. Case managers by their education and training are able to assess the family’s status for the need for respite care or make arrangements for such assessments with behavioral health professionals.

In addition to offering palliative physical care, professional hospice workers act as an emotional support base for the dying person. Death does not have to be a traumatic experience, but the process usually brings up strong feelings, desires, and concerns. Hospice care helps terminal patients experience their emotions with honesty and courage. It also helps them face tough spiritual questions that may arise as the end of life nears.

Hospice also provides social support for patients with a limited life span. Loneliness, anxiety, and anger are all natural parts of the dying process. It helps to have experienced professionals who can provide a listening ear and practical advice for day-to-day coping. It also helps to connect with other terminal patients in support groups, counseling sessions, or recreational activities. Families often find that the hospice model of care was just as supportive and therapeutic for them as it was for the dying patient. Over many years I have personally been told by countless families of the wonderful support and experiences and “blessings” that hospice provided to them and their dying family member during their time of crisis and the patients passing. It is not uncommon to learn that a hospice nurse, a social work, a case manager, or several from the hospice team will attend the calling hours or funeral when the patient dies. Bonds are formed between the team, the patient and the families when working together in such a highly emotional environment and situation. This is just the nature of the hospice model of care.

Another incredible benefit of the hospice model of care is the on-going support to the families after the passing of the patient. Most hospice models of care provide for follow-up contact with the families on some type of on-going schedule and can provide them, as needed, referral services for grief counseling or other needed support services. Many hospices also provide an annual sponsored memorial service in which they invite families of their patients to come and join in a special service to memorialize all of their patients over the past year. As such, case managers can emphasize to families and the patients that there is continued support beyond the immediate care of the patient.

Hospice care may or may not be the right choice for you and your family. Most people find that at least some aspects of hospice care are greatly beneficial to helping manage the dying process. Before making a decision, discuss your options with your care provider and family members. Case managers play a critical role in hospice models of care today. They are educators, coordinators of care, and advocates for the patient and their families and can be very influential in assisting patients and families in better understanding the hospice model of care so that sound decisions about care in the final stage of life can be better made.

Interested Health Care Professionals who would like more information on our Case Management Continuing Education program, leading to Certification and Fellowship, may access information by clicking here.

Additional Resources

American Academy of Palliative and Hospice Medicine: Click Here

Creating an Effective Hospice Plan of Care: Click here

Is Hospice a Place Where One Goes to Die?: Click here

What is Hospice Care by The American Cancer Society: click here

Healthcare Manager Certification Article on Nursing and Adequate Supply

Supply is important for any hospital or healthcare department.  Supplies are critical for nurses to perform their duties and ensure patient health and safety.  With Covid, these supply lines have been challenged.  The importance of inventory is key to good Healthcare Management and keeping a department supplied is critical to success.

Keeping a department in healthcare supplied is key to patient health and nursing success. Please also review AIHCP’s Healthcare Manager Certification


The article, “How Hospital Supply Chains Impact Nurses, Patient Safety, and Margins”, from Managed Healthcare Executive Staff looks at some statistics and facts regarding supply needs and how it affects every aspect of care.  The article states,

“Nurses face significant supply chain management problems that impact efficiency, patient safety, and hospital margins, according to a recent survey from Syft, a leading national provider of healthcare inventory control and end-to-end supply chain cost management software and services.”

To read the entire article, please click here

Please also review AIHCP’s Healthcare Manager Certification.  The program is online and independent study and open to qualified professionals.  Also please review AIHCP’s Healthcare Case Management Program which is also online and independent study.  Both programs lead to four year certifications.

Healthcare Case Management Certification Article on Technology and Healthcare

Since Covid 19, the pandemic has forced telehealth into new unchartered waters but to continue the advancement in delivering high quality patient care, technology and healthcare must continue to work together well into the future.  Accessing rural and other hard to reach patients is a imperative as well as being able to supply high quality care to patients who lack technological support.

Future technology will make telehealth more critical and everyday. Please also review AIHCP’s Healthcare Case Management Certification


The article, “How Healthcare Organizations Can Break Down Barriers to Care” by Zafar Chaudry looks closer at how technology and healthcare can closer align for better patient care.  He states,

“These efforts impact every aspect of healthcare, especially the patient. Digital initiatives have made it possible for healthcare providers and patients to connect while maintaining social distancing, just as similar transformation efforts have enabled work from home for many industries and remote schooling for students. But there has been a downside to this trend. Many people don’t have the tools or the infrastructure in place to support remote connections.”

To read the entire article, please click here

Strengthening these connections between technology and healthcare will be a key trend as the future of healthcare continues to serve patients in ways never thought before.  Case Managers will no doubt also benefit from these abilities to better communicate with patients they could not monitor as close before due to logistics.

Please also review The American Academy of Case Management’s Healthcare Case Management Certification.

Healthcare Case Management Certification Article

Healthcare management is a key element in providing quality healthcare.  Unfortunately, the United States and its healthcare system ranks very low in comparison to other industrialized nations.  This has led to the necessity of utilizing healthcare managers to help provide better delivery of healthcare systems by a better understanding of healthcare data and its delivery, population health, competencies of professionals, and care coordination.

Better delivery and outcomes for healthcare are the product of good case management. Please also review AIHCP’s Healthcare Case Management Program


The article, “Managed Care-A Plan to the Future” by Patricia Kirkpatrick looks at the critical importance of Managed Care for the future of Healthcare in the United States.  She states,

“Value-based care is here to stay. By developing specific competencies in quality, population health, care coordination, data analytics, governance and care delivery, MCOs can empower their workforces to meet the challenges and opportunities presented by this new model—and ultimately improve health care outcomes for all.”

To read the entire article, please click here

Please also review the American Academy of Case Management’s Healthcare Case Management Certification and see if it meets your academic and professional goals.  The program is online and independent study and open to qualified professionals seeking a four year certification in Case Management

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Readmissions is a big issue in Healthcare management.  It is not only important to reduce readmissions for the overall health of the person but also to reduce penalties that limit Medicare funding.  Many hospitals suffer from too high readmission rates and it is critical that hospital management encourage safe and efficient practices to reduce readmissions.  Case Managers can play a big role in reducing unnecessary readmissions.

Good article on readmissions. Please also review AIHCP’s Healthcare Case Management Program and see if it meets your academic and professional goals


The article, “Understanding your Readmissions: How to Reduce Penalties” by Marie Stinebuck looks closer at ways to reduce readmissions.  She states,

“Hospitals already suffering from the financial hemorrhage of the COVID-19 pandemic will be hit again by the readmission penalty. More than 2,500, or 83 percent of hospitals in the U.S., will receive reduced Medicare funding for the 2021 fiscal year because of their readmissions from 2016 to 2019.”

To read the entire article, please click here

Please also review AIHCP’s Healthcare Case Management Program and see if it meets your academic and professional goals.  The program is online and independent study and open to healthcare professionals seeking a four year certification in Healthcare Case Management


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Healthcare can be confusing and costly but there are many things individuals do not understand in regards to finances and healthcare. Healthcare affordability is a big issue with the coming election and prices and payment policies are always at the front of voter’s minds.

Good article on healthcare finances. Please also review AIHCP’s Healthcare Case Management Certification


The article, “Four Myths About Healthcare Affordability” by Bird Blitch looks at payment options and ideas surrounding healthcare. He states,

“Even when we’re not dealing with a global pandemic and the subsequent economic crisis, paying healthcare bills is often confusing and overwhelming for patients. To make matters worse, there are many misconceptions patients have about healthcare finances, which adds to the confusion. Now is the time to debunk these common myths, some of which may be preventing patients from scheduling the care they need.”

To read the entire article, please click here

Healthcare can be costly but how we finance it can make it easier.  Please also review AIHCP’s multiple programs in healthcare, most notably AIHCP’s Healthcare Case Management Certification and see if you qualify.


Case Management Program Article on Project Managers for Healthcare

Healthcare sectors have been hit hard by COVID 19.  Many resources have been utilized to meet the needs of the pandemic.  Project managers have emerged as aides in helping healthcare face its growing challenges.

Project managers can help healthcare face its next crisis
Please also review our Case Management Program and see if it meets your academic and professional goals


The article, “How project managers can help the healthcare industry prepare for the next crisis” by Moira Alexander discusses how project managers can play a role in the next crisis.  She states,

“Virtually every industry was hit hard by COVID-19, but the medical sector suffered the greatest and still continues to feel the strain. Whether it’s hospitals, care centers, dentists, or private medical practices, there are opportunities for improvement—and that’s where project management professionals (PMPs) can play a pivotal role. ”

To review the entire article, please click here

Please also review AIHCP’s Case Management Program and see if it meets your academic and professional goals.

What are the Biggest Data Security Risks in the Healthcare Industry?

Padlock and keyhole in a printed circuit. Digital illustration.Written By Lucy Peters

The current global health crisis is doing more than wreaking physical havoc; it is also affecting data security, exposing potentially sensitive patient data and putting the efficient functioning of healthcare organizations at risk. In some parts of the world, there has been a 150% increase in cyber attacks in recent months, with the stress of the pandemic causing many organizations to lose sight of cyber security at a time in which it is most under threat from new advancements in AI and other technologies that make attacks swifter and wider in scope. What are the main threats to data security in the healthcare sector and what steps can be taken to reduce them?

Phishing Attacks

Prior to the COVID-19 outbreak, many organizations – including the Oregon Department of Human (ODHS) Services – fell prey to phishing attacks. Indeed, the latter suffered a breach affecting some 645,000 patients, compromising over two million emails after just nine employees responded to a phishing email. In order to counter this threat, organizations need to rely on technology such as multi-factor authentication to prevent malicious emails from making it to employees’ inboxes. Employee training is equally important in preventing cyber attacks; in some organizations, simulated phishing software is being used to train and test employees’ abilities to respond to such a threat. Investing in training is a highly efficient way to combat a problem that is costing companies hundreds of billions of dollars every year.

Insider Breaches

Research by Egress has found that about 63% of healthcare data breaches are caused by human error, while around 20% are caused by sending information to the wrong recipient. The famous UW Medicine breach (which exposed the data of around 947,000 patients) was caused by a misconfigured server that made private documents accessible to the public. Healthcare organizations should set up identity access management rules to be followed strictly by staff. They should also implement controls covering the printing of sensitive documents. New content aware print management tech tracks information on who printed a document, where it was printed, and the contents of a document. This can boost compliance and minimize security breaches.

Cloud Security

Research by MarketsandMarkets indicates that the cloud model is increasingly appealing for healthcare decision makers, as most organizations need solutions to deal with an exponential growth of patient data. The benefits of the cloud are indubitable, yet alongside them comes a host of new threats — including malware and ransom attacks. Solutions to the problem include performing regular backups (these should be stored offline or in a separate network from the main one), encryption, and the conduction of a full cyber risk assessment on all third party vendors and contractors.

The healthcare industry is increasingly relying on digital sources for the storing of sensitive data. Some of the main threats it faces include phishing, insider breaches, and cloud security issues. These can be tackled both through education of personnel and through the adoption of effective solutions such as efficient IT management services, a regular backup system, encryption, and the reliance on a professional IT team that is on the beat when it comes to new developments in cybersecurity threats – including AI-based threats.




Please also review AIHCP’s Case Management program and see if it matches your academic and professional goals.  The program in online and independent study and open to qualified professionals seeking a Case Management Program

Healthcare Case Management Certification Article on Care Management Aspects

Care Management has a variety of functions, from disease management to utilization management. These management techniques help increase patient outcome and reduce cost.  Case Management is hence a key part of the healthcare system and something many companies and facilities invest thousands of dollars in.  This is especially the case in training healthcare professionals in healthcare management

There are many elements to successful healthcare case management. Please also review AIHCP’s Healthcare Case Management Certification


The article, “What We Talk About When We Talk About Care Management” by Leah Marcotte and Joshua Liao looks at healthcare management strategies.  They state,

“Emphasis on care management has become ubiquitous in the era of value-based payment. At the vanguard of the movement, policy makers such as Medicare have emphasized care management via a variety of initiatives, ranging from payment models that encourage longitudinal care management1 to billing codes that reimburse clinicians for coordinating the care of patients who have chronic conditions”

To read the entire article, please click here

Please also review AIHCP’s Healthcare Case Management Program.  The program is designed to help train professionals in the area of case management.  Care and case management are key ingredients to healthcare and AIHCP’s programs continue to be essential in training professionals in Care Management.


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An important element in healthcare is coordination.  Good case management requires coordination between different departments and professionals.  Everyone needs to be on the same page and working towards one common goal.  This increases patient recovery and also minimizes unneeded expenses and relapses.

Good teamwork and coordination is key to delivering good patient care. Please also review our Case Management Certification


The article, “Five Key Steps for Better Healthcare Coordination” by Robin Figueroa discusses the necessity of team work and departments working together and coordinating.  She states,

“While “care coordination” can mean varying things to people, ultimately it’s about having a patient-centric approach that consistently anticipates and meets the needs of patients and their caregivers. Think of great care coordination as “seeing around corners” on behalf of patients—helping them know what’s next in their care and paving the way for care to happen more smoothly.”

To read the entire article, please click here

Please also review AIHCP’s Case Management Certification Program and see if it matches your academic and professional goals.