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    Case Management Programs and Quality of Care

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    Are case management programs more concerned with reducing cost or improving the quality of care?

    What are some limitations and strengths of a case management program?

    Will case management programs become a medical program necessity in the future?

    How important are gatekeepers to the case management process?

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    Solution Preview

    Case management is used in many different types of clinical or social settings, such as social
    work or healthcare. Any organization that provides services to the public or a group within the
    population may utilize case management. It is widely used in clinical settings, as a means of monitoring,
    assessing, and measuring outcomes for practice (Howe, 2005). Outcomes can include measures of
    satisfaction, quality of care, efficiency of services, and proficiency of healthcare providers.
    OptumHealth (2012) recognizes the main objectives of case management as reducing costs while
    improving quality of care. The organization also realizes that these objectives may not be compatible
    with each other. However, they are compatible when improved quality of care leads to greater
    efficiency, improved satisfaction of care, and better outcomes for patients. Higher levels of satisfaction
    and better outcomes translate into fewer resources utilized to achieve the same health outcomes.
    Therefore, when fewer resources are used to achieve the same goals, the patient care process becomes
    more efficient, thus reducing costs . While improved quality of care may be a stated objective for
    case management, ultimately the practice is a cost saving measure.

    Like other monitoring programs within an organization, case management does have some
    advantages and limitations. One of the limitations may be in lack of insight into the future care needs
    of patients. Case ...

    Solution Summary

    The case management programs and quality of care are examined.