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Hickam DH, Weiss JW, Guise JM, et al. Outpatient Case Management for Adults With Medical Illness and Complex Care Needs [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Jan. (Comparative Effectiveness Reviews, No. 99.)
This publication is provided for historical reference only and the information may be out of date.
Outpatient Case Management for Adults With Medical Illness and Complex Care Needs [Internet].
Show details| Source | Definition |
|---|---|
| AARP http://healthtools | Case management assigns the administration of care for an outpatient individual with a serious mental illness to a single person (or team); this includes coordinating all necessary medical and mental health care, along with associated supportive services. Case management tries to enhance access to care and improve the continuity and efficiency of services. Depending on the specific setting and locale, case managers are responsible for a variety of tasks, ranging from linking clients to services to actually providing intensive clinical or rehabilitative services themselves. Other core functions include outreach to engage clients in services, assessing individual needs, arranging requisite support services (such as housing, benefit programs, job training), monitoring medication and use of services, and advocating for client rights and entitlements. |
| American nurses association (ANA) http://www | Management directed toward serious conditions likely to require numerous providers and involve costly care. Case managers handle each case individually, identifying the most cost-effective treatments for extremely resource-intensive conditions, such as accidents, AIDS, cancer, major trauma, prematurity, and strokes. Huntington, J., (January 6, 1997). “Glossary for Managed Care” Online Journal of Issues in Nursing Vol. 2. No. 1. Available: www Nursing case management is a dynamic and systematic collaborative approach to providing and coordinating health care services to a defined population. It is a participative process to identify and facilitate options and services for meeting individuals' health needs, while decreasing fragmentation and duplication of care, and enhancing quality, cost-effective clinical outcomes. The framework for nursing case management includes five components: assessment, planning, implementation, evaluation and interaction. Definition attributed to American Nurses Credentialing Center in White P, Hall ME. Mapping the literature of case management nursing. J Med Libr Assoc. 2006 Apr;94(2 Suppl):E99-106. PubMed PMID: 16710470. |
| California Department Of Health Services http://www | Guiding the course of resolution of a personal medical problem (including the ‘problem’ of the need for health education, screening or preventive services) so that the recipient is brought together with the most appropriate provider at the most appropriate times, in the most appropriate setting. The objectives of case management of Member medical care are as follows:
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| Case Management Leadership Coalition (CMLC), 2004 http://www | Case managers work with people to get the health care and other community services they need, when they need them, and for the best value. |
| Case Management Society of America (CMSA), 2002 http://www | Case management is a collaborative process of assessment, planning, facilitation, and advocacy for options and services to meet an individual's health needs through communication and available resources to promote quality cost-effective outcomes. |
| Center for Medicare/Medicaid Services (CMS) http://www | Case management is the coordination of care and services provided to members to facilitate appropriate delivery of care and services. The organization implements case management for members. The goal of complex case management is to help members regain optimum health or improved functional capability, in the right setting and in a cost-effective manner. It involves comprehensive assessment of the member's condition; determination of available benefits and resources; and development and implementation of a case management plan with performance goals, monitoring and follow-up. Distinguishing features of case management
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| Commission Of Case Manager Certification (CCMC), 2004 http://www | Case management is a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates options and services required to meet an individual's health needs, using communication and available resources to promote quality, cost-effective outcomes. |
| Robert Wood Johnson Foundation, Research Synthesis Report No. 19 (12/2009) http://www | Care management is a set of activities designed to assist patients and their support systems in managing medical conditions and related psychosocial problems more effectively, with the aim of improving patients' health status and reducing the need to medical services. The goals of care management are to improve patients' functional health status, enhance coordination of care, eliminate duplication of services, and reduce the need for expensive medical services. |
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