Health care can be very confusing, especially in the United States. There are many important things that people who work in health care know about, but people who use health care do not. One such thing is case or care management. Most people outside of health care have never heard of it, but it is an integral part of the health care system.
The Case Management Society of America (CMSA) states:
“Care managers are advocates who help patients understand their current health status, what they can do about it and why those treatments are important. In this way, care managers are catalysts by guiding patients and providing cohesion to other professionals in the health care delivery team, enabling their clients to achieve goals more effectively and efficiently.”
What does this mean? Case managers have many duties, but the primary goal of a case manager is to be sure a person has everything they need to live the best life possible with a chronic illness or injury, or while recovering from an illness or injury. This may mean educating you on your new diagnosis of diabetes, making sure you have the equipment you need in your home to recover from a hip fracture, or giving you resources to help pay for your medications when you cannot afford them.
Case management falls under a big umbrella, and includes several professions. Case managers, sometimes called care managers, are often nurses or social workers who specialize in case management. They may be associated with a hospital or managed care company, or be self-employed.
The strength of the case manager is information. Do you need to find resources for medical flights? For medication subsidies? To negotiate your way through the health care maze because you have cancer? A case manager can help you with all of these things.
One example of case management in action is the Patient Advocate Foundation at http://www.patientadvocate.org/. This non-profit foundation assists people in keeping employment, dealing with chronic illness and debt crisis and removing obstacles that prevent needed health care. They do all of this for no cost.