11 Statistics About Embedded Case Managers

Tuesday, December 16th, 2014
This post was written by Cheryl Miller

CMS readmissions penalties and accountable care organization (ACO) cost savings were among circumstances driving some organizations to embed case managers, according to the Healthcare Intelligence Network’s (HIN) inaugural survey on Embedded Case Management.

The majority of the survey’s 125 respondents (68 percent) have embedded programs in place to meet the expanding demand for case management services across the healthcare continuum, with the intent of improving care and quality outcomes.

Sites for embedding or co-locating of case managers ranged from primary care practices (PCP) to the hospital discharge area.

Following are eight more statistics from the 2014 Embedded Case Management survey:

  • „„9 percent of respondents that don’t have such programs intend to implement them within the next 12 months.
  • The average monthly case load of an embedded case manager is 1 to 49, according to 34 percent of respondents. Slightly less than one third (32 percent) of respondents cite case loads of between 50 and 99 patients a month.
  • „„The majority of respondents (77 percent) prefer that embedded case managers be registered nurses; 55 percent prefer that they have a bachelor’s degree.
  • „„In addition to case management assessments (75 percent), provider referrals were a key factor in stratifying individuals for embedded case management, according to 52 percent of respondents.
  • „„In addition to the PCP and hospital locations, some respondents embed their case managers in skilled nursing facilities (SNF), sub-acute facilities, and oncologists’ practices.
  • Seven percent of survey respondents report program ROI between 2:1 and 3:1, and 3:1 and 4:1.
  • „„Patient satisfaction is among the greatest successes of embedded case management programs.
  • The biggest challenge of embedding case managers is maintaining a care management focus and communication, according to 22 percent of respondents.

Source: 2014 Healthcare Benchmarks: Embedded Case Management


2014 Healthcare Benchmarks: Embedded Case Management provides actionable data from 125 healthcare organizations leveraging embedded or co-located case management to improve healthcare quality, outcomes and spend — including those who apply a hybrid embedded case management approach. This report also shares highlights from embedded case management initiatives at Caldwell UNC Health Care, where case managers are embedded with primary care and employer sites; and Sentara Medical Group, whose highly successful hybrid approach to co-located case management utilizes case managers during home visits, in the hospital, in the primary care provider office, on the phone or via online virtual sessions.

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