{"id":3701,"date":"2012-08-30T17:00:16","date_gmt":"2012-08-30T21:00:16","guid":{"rendered":"http:\/\/www.poweryourpractice.com\/?p=3701"},"modified":"2025-07-15T16:55:21","modified_gmt":"2025-07-15T16:55:21","slug":"how-a-case-manager-can-help-you-coordinate-care","status":"publish","type":"post","link":"https:\/\/carecloud.com\/continuum\/how-a-case-manager-can-help-you-coordinate-care\/","title":{"rendered":"How a Case Manager Can Help You Coordinate Care"},"content":{"rendered":"<p>In the early 1990s, Barbara Starfield, a pediatrician and health services researcher, identified the four <strong>key attributes of primary care<\/strong>: ?rst-contact care, continuity of care, comprehensive care, and coordinated care.<\/p>\n<p>Two decades later, primary care providers are still working \u2013 and struggling \u2013 to make those features the reality at their practices, and with the Supreme Court recently <a href=\"https:\/\/www.carecloud.com\/continuum\/how-the-affordable-care-act-will-benefit-your-practice\/\">upholding the Affordable Care Act<\/a>, the concept of coordinated care has become even more significant.<\/p>\n<p><!--more--><\/p>\n<p>Committed to achieving care coordination at your practice? Consider bringing aboard a dedicated case manager, if you haven\u2019t already. Having a case manager (also referred to as a care coordinator or nurse health educator) can provide your practice with a deeper connection to its patient population, which will help them achieve better healthcare outcomes.<\/p>\n<p><strong>Why You Need One<br \/>\n<\/strong>A study from May of this year found that 90 percent of healthcare organizations were using case managers, and a huge area of growth was in primary care. 58 percent of primary care organizations reported using them in 2012, compared to just 14 percent in 2011.<\/p>\n<p>This growth is attributed largely to the expansion of the patient-centered medical home (PCMH) and <a href=\"https:\/\/www.carecloud.com\/continuum\/acos-your-practice-can-they-work\/\">accountable care organization (ACO)<\/a> models of primary care administration. In light of that, you may think a case manager is unnecessary at your practice if you\u2019re not interested in becoming a PCMH or ACO \u2013 but you\u2019d be thinking wrong.<\/p>\n<p>Regardless of healthcare reform, <strong>coordinated care is critical to primary care<\/strong>, and using a case manager is the easiest way to achieve it.<\/p>\n<p>A case manager is usually a registered nurse, which means she possesses a great deal of first-hand healthcare knowledge and experience. But she doesn\u2019t use it to deliver clinical services or tend to the administrative needs of your office.<\/p>\n<p>Instead, a case manager uses her expertise to conduct patient education, condition management advice, coordinate appointments, communicate among various provider organizations, work with Medicare or a patient\u2019s private insurance, and generally just <strong>help patients navigate the maze<\/strong> of the American healthcare system.<\/p>\n<p>A case manager becomes your patients\u2019 point-of-contact and oftentimes serves as their advocate when it comes to fighting problem claims, securing hard to get appointments, and making sure their healthcare data gets to into the right hands.<\/p>\n<p>In this article from amednews, one physician said her practice\u2019s case manager does things she could do but doesn\u2019t have time to. Considering how valuable a physician\u2019s time is, that makes a case manager one extremely valuable asset.<\/p>\n<p><strong>How to Get One<br \/>\n<\/strong>Hospital-owned providers, especially those who are recently acquired, are frequently approached by their health organization to place an appointed case manager into their practices. Others are being approached by health insurers with a similar offer.<\/p>\n<p>The introduction of a case manager via placement by an outside entity makes some doctors leery, especially those accustomed to handling any and all hiring decisions.<\/p>\n<p>Yet the <strong>advantages to having a case manager<\/strong> around are so great that, despite hesitations, if the offer is posed to you it\u2019s wise to consider it, so long as the health system provides you with an opportunity to interview the candidate, plan out the scope of authority you\u2019d have over her execution of job duties, and decide whether she\u2019s <a href=\"https:\/\/www.carecloud.com\/continuum\/3-ways-stop-doctor-shortage-hurting-practice\/\">a good fit for your practice<\/a>.<\/p>\n<p>Those who aren\u2019t offered such placement \u2013 or can\u2019t shake skepticism about taking in an outside rep \u2013 should consider bringing in case managers of their own for the sake of their patients. Speak to colleagues who already have case managers working in their practices.<\/p>\n<p>Ask around for recommendations, write up job descriptions based on the qualifications and duties of their existing CMs, and solicit a new hire if you\u2019re ready to make the addition.<\/p>\n<p>A case manager can make your practice more patient-centered and enhance your services through increased accessibility, continuity, comprehensiveness and \u2013 most importantly \u2013 coordination. That\u2019s the kind of primary care performance that\u2019s been decades in the making\u2026 and can be a reality in your practice.<\/p>\n<p><strong>Do you have a case manager on staff? How has it impacted your patients?<\/strong><\/p>\n<p>Want to learn more about achieving high-performing primary care? Check out this resource.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>In the early 1990s, Barbara Starfield, a pediatrician and health services researcher, identified the four key attributes of primary care: ?rst-contact care, continuity of care, comprehensive care, and coordinated care. Two decades later, primary care providers are still working \u2013 and struggling \u2013 to make those features the reality at their practices, and with the [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":32786,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,8],"tags":[],"class_list":["post-3701","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-revenue","category-trends"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>How Case Manager can help you Coordinate Care - Continuum<\/title>\n<meta name=\"description\" content=\"Committed to achieving care coordination at your practice? 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