CASE MANAGEMENT INSIDER. Thinking of Separating Utilization Management and Case Management? Think Again!

Area of Science:

• Healthcare Management
• Patient Care Coordination
• Social Work

Background:

• Fragmented case management models often separate roles, leading to disjointed patient services.
• This separation can result in a lack of integration with patients' current and long-term care needs.

Purpose of the Study:

• To advocate for patient-centric case management models.
• To highlight the ineffectiveness of fragmented roles in case management.

Main Methods:

• Analysis of existing case management models.
• Evaluation of the impact of role separation on patient care.

Main Results:

• Separating case manager and social worker roles creates disjointed care.
• The argument for collaborative models being less expensive is not supported when roles are fragmented.

Conclusions:

• Integrated case management, where roles are performed as a package of services, is essential.
• Maintaining integrated case management functions maximizes success and achieves optimal patient outcomes.