A Case for Integrated Case Management
Lower Health Costs and Improve Health Outcomes
in Complex Patients through Integrated Care Management
Now that 30 million more Americans will be covered as a result of insurance reform legislation, health system stakeholders are looking for innovative ways to reverse high health care expenses associated with the current system's fragmented care, especially for patients with health complexity, high health care service use, and functional impairment. Integrated case management (ICM), as a component of population health management (PHM), provides an evaluation and care support process, which could incrementally change health outcomes and expense for the five percent of patients that use nearly half of health care dollars and add to societal costs through lost productivity and utilization of public programs.
ICM targets patients with health complexity trapped in a siloed care delivery system. Unlike traditional care management
approaches, its managers are trained in assisting with interdisciplinary conditions, including medical and mental health, and with social and health system support. They use a patient-centered, relationship-based approach during a comprehensive assessment of health complexity. Assessment findings are summarized in a grid through which the manager, the patient, and/or caregiver, and the patient's clinicians can decide on holistic goals and actions that will lead to "measured" clinical, functional, quality of life, satisfaction, and fiscal outcomes. ICM is a transformative interdisciplinary care management process that should be an integral part of care delivery reform as patient-centered medical homes, accountable care organizations, and other innovative care delivery programs are formulated.
Cheri A. Lattimer, RN, BSN
Case Management Society of America
Learn more about Cartesian Solutions, Inc. at their website: