More care teams should take advantage of case management

January 1, 2010

Coordination of care helps decrease costs and ensures effect use of resources

Case management can offer solutions for a multitude of issues, including:

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Case managers should be a critical component of any collaborative team approach, yet healthcare administrators may not always take full advantage of the capabilities of a best practice case management program or the cost savings those programs can provide. Programs, for the most part, are available in many areas of the healthcare continuum, including: the hospital, skilled nursing facilities, outpatient clinics, home care, rehabilitation, worker's compensation, community settings, large primary care and specialty offices.

Healthcare executives who increase the utilization of such departments moving forward might find a coordination and communication hub that will lower healthcare costs by ensuring a more effective system for individuals to receive support and interventions for their complex needs.

The Case Management Society of America (CMSA) believes significant gaps exist between the association's published definitions of a qualified case manager and the variety of more subjective interpretations by various healthcare stakeholders. Case management services can reach full potential as one of several solutions for healthcare issues, but managed care must embrace and implement consistent programs to provide the care coordination needed by complex medical patients and patient populations dealing with chronic care management.

There are several reasons for the inconsistency identified in various case management programs. Some reasons include:

In the last two years, CMSA has revised its Standards of Practice to include many of the coordination aspects required to meet the needs of improved communication and transition coordination. Many organizations and academic institutions use the standards as guidelines in developing and implementing case management programs.