Continuity of care and the control of costs: can case management assure both?

Case management is increasingly extolled as a mechanism to improve services in both health and mental health settings. However, in mental health service systems, case coordination of services is at the client level, while in health services it is applied mainly as a means to manage care and control costs. This paper discusses the background of case management, the policy and management conflict that is arising between the goals of cost control and continuity of care, and a number of steps to reduce the negative effects of these competing policies and goals.