Managing case management across the continuum: an organized response to managed care

Area of Science:

• Healthcare Management
• Health Services Research

Background:

• Case management is vital for quality, cost-effective care within managed care settings.
• Nursing-driven, hospital-based programs are common origins for acute care case management.
• Vertical integration trends necessitate evolving case management strategies beyond traditional hospital settings.

Purpose of the Study:

• To examine the evolution of hospital-based case management programs.
• To propose strategies for adapting case management to integrated health systems.
• To outline considerations for designing case management systems across the continuum of care.

Main Methods:

• Literature review on case management models.
• Analysis of trends in healthcare integration.
• Description of strategies for continuum of care case management.

Main Results:

• Hospital-based case management may be a transitional model.
• Integrated health systems require expanded case management approaches.
• Continuum of care design is key for future case management.

Conclusions:

• Case management must adapt to integrated healthcare environments.
• Leadership should plan for expanded, system-wide case management.
• Designing for the continuum of care is essential for future success.