“Our time has come!” was how our special guest host Bonnie Geld, President and CEO of the Center for Case Management, began her presentation to case managers last week. As part of our thought leadership webinar series, Bonnie joined us to discuss the changing landscape of the healthcare industry, how case management has evolved into an essential function in health systems, and a new paradigm for case management that facilitates the delivery of coordinated care across the continuum. Read on for a recap of key points in her presentation and then download the full webinar recording here.
A National Imperative for Change
There is a clear mandate for change today within the U.S. healthcare system, driven by the harsh reality that we have both the highest costs and poorest outcomes in the world. Case management professionals in all settings have witnessed a shift in payment models, away from per diem and toward value-based models. In both CMS programs and arrangements with commercial payers, hospitals and health systems are taking on more risk and being held accountable for patient outcomes. These organizations are realizing that to succeed with outcomes-based reimbursement, they must be able to track patients across all care settings, connecting the dots across the continuum.
The Challenge and the Good News
A common challenge encountered among case management teams is achieving standardization and synchronization across a health system. However, the prioritization of coordinated care across the continuum is helping to overcome these hurdles. In addition, there are a number of new tools and technology platforms available to assist case management teams as they work to launch unified care plans that span the continuum. In a value-based context case management is viewed as both a strategy and a solution to help health systems succeed; it is getting the recognition it deserves and being viewed as high value.
A New Case Management Paradigm
Just like health systems need to start tracking their patients after discharge from the hospital, case managers also need to look beyond three- or four-day acute inpatient episodes. Whereas the traditional case management approach was episodic, siloed, and task-oriented, the contemporary approach is longitudinal, thinking past discharge and focused on coordinated care and sustainable transitions.
The deliverables of the new case management paradigm include:
- Managing cost per case
- Delivering plans that are realistic, cost effective, and longitudinal
- Creating sustainable, comprehensive systemwide transitions that leverage the care continuum and result in good outcomes for every patient
- Ensuring case managers and social workers understand patients, families, teams, and resources deeply but quickly
- Customizing care at the same time that we are “mass producing” results
To learn more about the shared beliefs, processes, and technology that support the new case management paradigm, download the full webinar recording.
And be sure to sign up for our October webinar with Nick Stupakis, Vice President of Highmark Home and Community Services.