3 Post-Reform Priorities for Case Management: Collaboration, Integration and Extension

Today’s case managers have to be capable of dealing with both physical and mental health issues, says Teri Treiger, RN-BC, MA, CHCQM-CM/TOC, CCM, CCP, president of Ascent Care Management. Many case managers don’t feel comfortable dealing with mental health issues, but patients with dual diagnoses, including behavioral problems, need consistency, and shouldn’t be pushed back and forth between a behavioral case manager and a medical case manager. Case managers who can work “across the aisle” are rare but necessary.

There are many emerging trends in case management, but there are three I want to touch on here. The first is the trend of case management-led collaborative teams. This is a hot button because it’s believed that the team should always be led by one particular person, be it the physician, nurse practitioner, or another prescribing provider. But when you think about what we do as care coordinators or case managers, it’s a lot of detail that the prescribing provider does not have time for. Sometimes we as case managers don’t even have time to get it all done, so working in collaborative teams where the case manager is a controller, so to speak, inclusive of a nurse, a social worker, a behavioral health specialist, and administrative staff, because somebody needs to know what’s going on in all of those different areas. And, with no disrespect to physicians intended, it probably can’t be the physicians, because they have way too much else to do to get down to this level of granularity.

Integrated care management is another trend; we have to stop separating people’s heads from the rest of their bodies. We have to be inclusive of both physical and mental health. It’s an absolute essential. Integrated case management programs are expanding. A case manager who has grown up and worked within the medical realm doesn’t necessarily feel comfortable dealing with mental health issues. But the patients that have dual diagnoses should not be pushed back and forth between the behavioral health case manager and the medical case manager. They don’t do well with that level of inconsistency in their care management. Having one case manager who can work across the aisle, so to speak, is rare but necessary.

And finally, we’re seeing more use of case management extenders, like nurse’s aides or administrative staff. They are a fabulous resource. Case managers don’t need to be calling transportation, making Meals on Wheels arrangements, and performing other more administrative tasks. But we can’t just create a team of case management extenders and let them run wild; we need to come back to that case management-led collaborative team.

I often use the example of having a patient, Mrs. Smith, who is diabetic and needs Meals on Wheels. It’s just a matter of Susie (the extender) calling and making the arrangements for Meals on Wheels, understanding the details of the task. Having these extenders is a great opportunity, because case managers can become more efficient and focus on the clinical issues that they need to and have a great collaborative team experience.

Source: Case Management in Value-Based Healthcare: Trends, Team-Building and Technology

Case Management in Value-Based Healthcare: Trends, Team-Building and Technology

Case Management in Value-Based Healthcare: Trends, Team-Building and Technology delivers advice for the profession on surviving and thriving in the post-reform healthcare landscape. From protecting the case management title to averting a patient backlash from care transition management, the former national president of the Case Management Society of America and past president of the Case Management Foundation addresses the game-changing state of healthcare case management today.

This entry was posted in Behavioral Health, Care Coordination, Case Managers, Case Managers and the Patient Experience and tagged , , , . Bookmark the permalink.
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