The Healthcare Case Manager's New Role
Healthcare case managers are taking on more responsibility in the care coordination continuum from management of the chronically ill in primary care to overseeing post-acute transitions in care to educating patients on appropriate use of the emergency department.
Market research by the Healthcare Intelligence Network indicates that 85 percent of healthcare organizations are using case managers, with many companies co-locating case managers alongside healthcare providers.
To assist you and your organization learn from the industry's best practices in case management, weve assembled a series of resources on case management...from case studies with industry leaders to to a case management benchmark guide with key metrics for case management programs.
Table of Contents
Post-reform redesign of clinical care delivery and supporting reimbursement models reflects the healthcare case manager's dual roles as care coordinator and utilization manager. Case manager work locations, job focus and caseloads are evolving in response to these shifts in the healthcare landscape.
2011 Benchmarks in Healthcare Case Management: Responsibilities, Results & ROI provides actionable information from 201 healthcare organizations on the prominence, placement and responsibilities of case managers as well as case management-driven results in healthcare utilization, cost and compliance.
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The 118-page Guide to Patient-Centered Case Management presents best practices in identifying, stratifying and monitoring individuals for case management and documents the returns generated by targeted case management interventions in place at Geisinger Health System, Community Care of North Carolina and other organizations. The Q&A chapter answers more than 50 questions on patient-centered case management.
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Healthcare organizations are positioning case managers along the healthcare continuum and at routes of entry to coordinate care for complex patients, manage transitions between care sites and reduce avoidable consumption of health resources. Embedding a case manager at the point of care is increasingly good business.
Best Practices in Contemporary Case Management examines three separate case management initiatives that generated these results and others, detailing the impact of these programs on health outcomes, care delivery and resource utilization.
Working within the ProvenHealth Navigator(SM) Geisinger's home-grown medical home model case managers are carefully matched with primary care practices, where they help the practice to identify its highest-risk population and develop customized care plans to guide those individuals to better self-management of their condition and more judicious use of healthcare resources.
The Medical Home Case Manager: Profiting from Patient-Centered Care Coordination provides an inside look at the selection, training, skill set, processes and benefits of the Geisinger Health Plan case managers embedded within the payor's medical home practices.
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