With health reform driving value-driven care transformation, partnering care managers and social workers with physician services has the potential to impact the patient's experience as well as financial and clinical care outcomes. Care managers serve a significant role in improving the clinical quality of care by reinforcing a consistent and clear message by the health care team to the patient during the entire hospitalization, not just at the time of discharge. At one institution, partnering physicians with care managers through the acute care continuum (service-based care management) appeared to reduce readmissions without compromising patient satisfaction. Both readmission reduction and effective patient satisfaction scores impact the Centers for Medicare & Medicaid Services value-based purchasing reimbursement calculations.

Since the introduction of the National Patient Safety Goals (Joint Commission International Center for Patient Safety, 2005) into the Joint Commission on Accreditation of Healthcare Organizations standards, there appears to be a positive movement toward improvement in patient care outcomes and safety. Case management has been an integral part of the care team, and has emphasized standards of performance in quality of care, collaboration and resource utilization since 1995. When Leapfrog defined hospitalist intensivists as one of the three requirements necessary to be a safe hospital, an opportunity was borne to create a professional partnership. With the patient and the safety as the central focus of care, case managers and hospitalists are beginning to exponentially change the face of healthcare. This article will demonstrate the value of this partnership.

In 2008, the Centers for Medicare and Medicaid Services (CMS) implemented a provision that denies Medicare payment for hospital-acquired conditions (HACs). This provision brings attention to the quality of patient care and the financial impact associated with "never-events" occurring during a patient's hospitalization. Our review of HACs focuses on the 5 which are most pertinent to the neurohospitalist: stages III and IV pressure ulcers, catheter-associated urinary tract infection, vascular catheter-associated infection, manifestations of poor glycemic control, and falls resulting in fractures, dislocations, and/or intracranial injuries. We address why CMS came up with them, their impact on quality patient care and hospital finances, and how the neurohospitalist can continue to participate in the future of HAC prevention and management as they relate to one's patients, hospital, and community.