What is Case Management?

Case management, also known as care coordination, is a service that is provided to patients with disabilities or medical conditions to help them achieve their highest level of wellness. Whether it’s a patient who has been diagnosed with a chronic condition and is in need of a plan of action, or someone who has been discharged and is looking to procure medications and supplies, a case manager is an important advocate who can help patients understand, evaluate, and address their medical journey every step of the way.

Benefits of Having a Case Manager

Because case managers are specialized healthcare professionals with deep experience in their respective fields, they are equipped to help patients navigate a complex system that can easily become overwhelming or confusing. A case manager will meet with their patients regularly to understand their health goals and needs, and are there to ensure that their patients receive effective care with the resources they have at hand. These services can expand into additional areas such as mental health, vocational services, and rehabilitation as well. Some case managers’ main duties include:

  • Direct line of communication: Case managers are the liaisons that connect patients with appropriate providers and insurance agencies to keep all parties informed as they coordinate the patient’s healthcare services. By establishing a close relationship with a patient’s health care provider, case managers can help their patients learn more about their disease or injury and make better-informed choices regarding their treatment.
  • Healthcare Coordination and Follow Through: For patients who require care around a specific condition or disease, case managers will ensure that medications are received properly and on time, help with refills, schedule appointments, and assist with the purchase and maintenance of assistive devices. They can also arrange therapies and medical services and assist with associated financial tasks such as insurance claims, medical bill analysis, and bill pay.
  • Improve Quality of Life: Not only do case managers support and advocate for a patient’s diagnosis and treatment, but they are also helpful in ensuring that a patient can live as comfortably as possible long after they have been discharged. Case managers can coordinate and arrange home health services, housekeeping, transportation, food delivery services, home modification, and employment services and job placement. They can even incorporate a patient’s community, family, and friends to assist in their plan of care for companionship and support as needed.
  • Cost-Effective Outcomes: Case managers are responsible for leveraging their resources to create a personalized patient plan that is as cost-effective as possible. Case managers will be able to negotiate with the pharmacy, home healthcare company, and health insurer to drive overall costs down, and can also help enroll patients in hospital financial relief programs and grants where applicable.

Who Should Have a Case Manager?

Case managers today work across a broad range of specialties and are not limited to working with people with disabilities or injuries. Children or adults who are battling addiction, mental illness, or other types of chronic conditions can all benefit from the services provided by a dedicated case manager to help with their complex care needs.

Our qualified case managers at CRC use a multidisciplinary approach to support patients in safe, effective, and timely ways, providing all the services discussed in the article and more. To learn more about our Case Management services, contact us at 305-299-4817.