What we talk about when we talk about care management

Area of Science:

• Healthcare Management
• Health Services Research
• Value-Based Healthcare

Background:

• Effective care management is crucial for value-based care success.
• Existing frameworks may not adequately address the multifaceted nature of care management.
• Need for structured approaches to optimize patient outcomes and resource allocation.

Purpose of the Study:

• To propose a novel framework for categorizing care management interventions.
• To provide a clear structure for understanding and implementing care management strategies.
• To support the development of effective care management programs within value-based care models.

Main Methods:

• Conceptual framework development.
• Literature review on care management and value-based care principles.
• Categorization of interventions into distinct domains.

Main Results:

• A proposed framework categorizing care management into three primary types: disease management, utilization management, and care navigation.
• Defined characteristics and objectives for each category.
• Highlighted the interconnectedness of these interventions.

Conclusions:

• The proposed framework offers a structured approach to care management.
• Categorization aids in program design, implementation, and evaluation.
• Supports the strategic alignment of care management with value-based care goals.