Care Management

Care management is team-based, person-centered approach “designed to assist individuals and their support systems in managing medical conditions more effectively.” It also encompasses care coordination activities needed to help manage chronic illness or serious behavioral health issues.

A strong care management approach ensures the integration of systems, science, incentives, and information to improve the well-being of individuals with needs that cross multiple systems (health care, behavioral health, housing, employment, etc.)

The goal of a care management system is to ensure that individuals receive the right services, at the right intensity at the right time to improve their overall health, economic and social well-being.

Additionally, care management is intended to assist consumers and their support system to become fully engaged in the management of their own care and treatment.

Individuals with more complicated physical and/or mental illnesses are at increased risk of potentially serious, even fatal, exacerbations and complications. They benefit from more intensive follow-up and care management. Evidence suggests that well-organized care management can reduce an individual’s risk of deterioration and hospitalization and results in the delivery of cost effective, non-duplicative services..

The critical components of effective care management include:

  • Engaging Individuals—including the “hard to engage” individuals who may not see the need for or the benefit of care management. Engaging the hard to engage requires patience and the willingness to “go the extra mile” to overcome fears and anxiety.
  • Removing Barriers—there are many barriers to accessing services including transportation, language, child care, fear and more. Care management works to eliminate these barriers, making access to services easier.
  • Coordinating Care—when an individual has multiple needs it can be challenging to know when to start and how to sequence the interventions. A good care manager understands that it is a set up for failure to expect an individual to attend a large number of appointments in any given week. The best approach is to have a deep understanding of the needs of the consumer, his/her existing day to day demands, and then to sequence services to address most critical issues with the intensity required.