In the healthcare sector, two common terms named case management and care management services are often heard. These are distinct but comprehensive approaches in helping individual patients to achieve optimum health and in improving quality of life.
In case management, professionals address short-term and acute needs of patients, while care management focuses on proactive and long-term support for chronic health conditions. Let’s explore how they differ and work together in helping patients to achieve holistic healthcare.
What exactly is Case Management?
In case management, healthcare services are managed during acute medical situations, such as strokes, surgeries, or emergency hospitalisations. Here, a dynamic patient solution is created through assessment, monitoring, care coordination and planning. The aim of case management is to improve clinical outcomes, mitigate discomfort and improve patients’ quality of life.
What does Care Management Truly Mean?
On the other hand, care management acts as a broad healthcare strategy to deliver high-quality, collaborative and preventive care to patients. It provides accessible and individual care to sufferers, helping them deal with chronic illness and complex healthcare challenges.
A care management program includes removing outstanding gaps in care, improving care coordination among healthcare providers and supporting continuous patient education.
Who are Case Managers and their Core Duties?
A case manager is a certified professional to conduct case management practice. They have knowledge and professional expertise in healthcare and nursing. Below are their core role:
- Monitoring patient progress through analysis of vital signs and collecting biometrics
- Finding out an individual client’s care needs and making plans for and execution of corresponding and comprehensive care.
- Lowering hospital readmissions, needless resource usage, and healthcare costs.
- Providing financial resources and advances for the well-being of patients.
In essence, a case manager fills up the gap between patients and quality care, aiming to deliver better health outcomes.
Who are Care Managers and their Major Responsibilities?
A care manager is a professional who collaborates with patients and health care service providers. They aim to assess their clinr;s unique healthcare journey and offer a streamlined solution to promote comprehensive care. Their major responsibilities include:
- Connect with patients to review their care plans and symptoms.
- Coordinate appointments, screenings, and transportation as needed.
- Supporting medication management, which includes refills and delivery.
- Educate patients about their conditions, offering self-management tools.
- Link patients to community resources for food, housing, or financial support.
- Provide emotional support to sufferers from anxiety, depression, or loneliness.
Their efforts empower patients to take control of their health and improve overall quality of life.
Care Vs. Case Management: Key Differences
While these healthcare processes have some common goals, each approach has essential operational ways. Here are their major differences:
1. Patient Eligibility
Case Management:
Case management eligibility is complex. Rather than a patient and their provider, it’s initiated by third-party stakeholders. Its eligibility is determined by a patient’s healthcare needs, available funds, resource utilisation, and other relevant aspects, which are determined by healthcare professionals, state departments and insurance companies.
Care Management:
Care management is offered by a Chronic Care Management(CCM) provider. It is available to any Medicare-enrolled patient having two or more chronic conditions who received service from them in the past year. They must get permission to enrol in a CCM program and receive monthly support and care from care managers.
2. Aim and Focus
Case Management:
In case management, focus is given to managing acute levels of a specific disease to stop it from progressing. It serves those sufferers who often deal with more complex, critical illnesses.
Care Management:
It focuses on preventive care, where accessible services are offered to maintain a patient’s current health condition and safeguard it from declining further. A strategic plan is made to help patients manage their conditions and maintain their health.
3. Services Offered
Case Management:
Generally, case management service requires monitoring critical signs or other assessments of a patient’s clinical condition. Case managers seem to handle complex tasks based on the demands granted by individual patients’ case details.
Care Management:
Here, professionals in Chronic Care Management offer healthcare services through telephonic or virtual platforms. Common CCM activities involve assisting with medication adherence, SDoH interventions, transportation help, and preventative assessments.
4. Professional Background
Case Management:
Multidisciplinary case management teams are generally led by licensed Certified Case Managers. They have expertise in social work or nursing activities in helping people to get out of discomfort and live a quality of life again.
Care Management:
It can be performed by different individuals, including clinical health coaches,expert administrative staff and licensed providers. Many healthcare firms arrange practice programs with trained care manager teams, so they do not have to depend on in-house resources.
Bottom Line
As you can see, care management and case management have their similarities along with differences. At their core, both support patients throughout rehabilitation and help them achieve better health. Both are necessary and neither replaces the other.If you or your loved one is looking for comprehensive case management services, contact Premium Legacy Healthcare. Our expert case managers will thoroughly listen to your concerns and develop a customised recovery strategy. Consult us and find the right care and support!