Case Management Role

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Although case management programs are centralized around both concepts of saving money while also improving the quality of care, in my opinion, case managers put more emphasis on improving the quality of care. Case managers do, however, have a significant impact on financial costs by ensuring a positive progression of a patient’s care, but also can ensure that an insurance companies guidelines are being met (Daniels and Frater, 2011,8). In the hospital setting, case managers are able to improve outcomes. They are also able to reduce hospital readmission risks by improving care coordination and eliminating gaps in care that lead to unnecessary readmissions. They are can help to avoid waiting on transitions of care by coordinating directly…show more content…
Case managers are not only responsible for ensuring that patient care is delivered appropriately for each patient, but also that the health care facility receives reimburse for that care. As a result, case managers make significant contributions to the bottom line of health care facilities (Fink-Samnick et al, 2013,3). Case management is taking on a more patient-centered approach, which implies that selection and coordination of services is done from the patient’s perspective and in consideration of the patient’s circumstances. It encompasses primary care and psychosocial needs, management of chronic conditions, timely access to care, improving relationships between patients and their providers, and providing patient education, while also controlling health care costs. In a study in 2007, a patient-centered approach improved quality, reduced readmissions, and decreases overall costs (Consonery-Fairnot,…show more content…
When case management is accomplished in this manner, costs are contained and patients and caregivers are viewed as critical participants of the team. Case management is a fluid and dynamic practice that is most effective when it changes and adjusts with the challenges of the health care system. Stewardship of the health care dollars, appropriate transitions of care, evaluating patient adherence, and consistent communication are critical interventions that case managers employ, while maintaining a primary and constant focus on quality of care and patient satisfaction. Case managers are able to proactively address problems regarding a patient’s treatment plan and can intervene early to make changes as needed. This in turn improves the patient’s quality of care (ANCC,
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