Healthcare systems have become increasingly complicated. With a growing aging population, and a rise in chronic conditions, value-based care that focuses on quality instead of quantity of services has risen in demand. To achieve this, the need for specialized individuals to help guide patients and their families or caregivers through the healthcare system has increased, making Case Managers essential.
What is Case Management?
Case management is a specialty practice that focuses on patient-centered care. It includes assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet patients’ health needs. A case manager will work with a patient to help them find and receive the care they require to manage their diagnosis, illness, or injury. They can connect individuals to doctors, resources, education, and other services depending on what each case needs.
Who are Case Managers?
According to the Case Management Society of America, a case manager is a healthcare professional that serves as a patient advocate to support, guide, and coordinate care for patients, families, and caregivers throughout their health and wellness journey. Case managers can be registered nurses, social workers, or other medical professionals. They are known by many different titles such as Care Managers, Discharge Planners, Life Planners, and more. No matter what title they go by, they all have the same goal: helping patients successfully navigate the healthcare system and manage their health.
Case Managers assist patients of all ages, from infancy to end-of-life care, including high risk populations such as maternal, pediatric, complex medical, and mental health populations.
How Can They Help?
Case managers are available anywhere that you receive care. Their responsibilities include client identification, engagement, assessment, development of a person-centered care plan with prioritized goals, implementation of the care plan, monitoring and evaluation, and closure of case management services.
They can help you understand what you are going through, what you need to do next and why, what resources are available to you, insurance benefit information, how to manage day-to-day healthcare needs, and where you can find the care you need when you need it.
The Philosophy of Case Management
According to the Case Management Society of America, “when an individual reaches the optimum level of wellness and functional capability, everyone benefits: the individuals being served, their support systems, the health care delivery systems and the various reimbursement sources”. This is why case managers are dedicated to providing the coordination of services needed by patients to help them manage their condition, illness or injury effectively.
https://cmsa.org/who-we-are/what-is-a-case-manager/
