Case Managers: Taking an Active Role as Healthcare Evolves

| URAC Staff
Case manager engaging patient

As the healthcare industry continues its efforts toward improved health outcomes, lower costs, and value-based reimbursement models, case managers have an opportunity to play an even more critical role, said Cheri Lattimer, RN, BSN, executive director of the National Transitions of Care Coalition. While this profession encompasses a number of important responsibilities in healthcare organizations, Lattimer points out three specific areas of growth in 2017 for case managers: patient engagement and education, transition planning, and role development.

Patient engagement and education
Multiple bodies of research, including a 2015 study by George Washington University's School of Nursing, have suggested increased patient education and engagement is linked to improved health outcomes, which highlights its importance in both case management and healthcare in general.

Patient and family/caregiver education is more important than ever, said Lattimer. Giving patients,  and others in their lives, the tools they need for informed decision making encourages them to become more engaged and involved in their own care.

Transition planning
As healthcare organizations move toward value-based care, creating effective, collaborative care teams becomes a high priority. Case managers play a significant role in this new structure, particularly in the transition period when responsibility for a patient is transferred from one provider to the next.

"Improving the transition planning is a key role that we see for case managers," Lattimer said.

She added that the transition process and sharing information across the care team in general are increasingly essential responsibilities of case management that have a direct impact on the patient.

Role development 
As case management evolves, the professionals who work in these positions should not sit idly by. Lattimer encourages case managers to take an active part in the development of the role, particularly in terms of researching and establishing the value and return on investment of case management.

"We need to be flexible in working with our patients, but we also need to have a voice in this," Lattimer said. "With our voice, we will be able to look at how we can become better at what we do how we can support [these changes] across the board."

Hospitals, health plans, accountable care organizations, provider-based practices, clinics and other healthcare groups are taking additional steps to optimize case management performance as the role develops.

One way is through accreditation. URAC's Case Management Accreditation with Measures addresses the increased demand for excellence in this role, while helping organizations establish the structure, procedures and policies they need to ensure optimal performance in the workplace.

As care management evolves and encompasses new responsibilities, Lattimer said that the ultimate goal stays the same:

"We need to stay focused on what I hope brought every one of us into this delivery of service: the patient and family or caregiver and how we can work as a community to improve that process for them."

Lattimer presented URAC’s webinar, “Trends, Challenges, and the Growing Roles for Case Management in 2017.” Click here to register for the on-demand webinar for free.

Explore URAC’s Case Managaement Accreditation 

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