Case management is a coordinated effort between community-based, often nonprofit, organizations that work to provide quality health care solutions that are customized to a client’s specific and individual needs. This health care approach is designed to be customized to the client to best address unique needs on the client’s own timeline. In addition to traditional health services, case management can also aide with employment searches, transportation solutions, and community involvement. This collaborative process involves assessment, planning, plan implementation, and evaluation to successfully achieve the client’s desired outcome.
There are four basic levels involved with case management - intake, needs assessment, service planning, and monitoring and evaluating - which will be analyzed here. It is important to note that while these levels are numbered one through four for the purposes of this discussion, they are not necessarily linear. Case management levels can be revisited as needed depending on how well the case manager and client are navigating their plan.
Case managers are health service professionals who work toward the goal of bettering the life and needs of their clients. Case managers will work with clients, the client’s family, community members, and other health professionals to address their clients’ individual and specific needs. Case managers are responsible for making sure their clients have the resources they need to meet their agreed-upon goals. As health professionals, case managers must also advocate on behalf of their clients as these individuals are often not in a position to advocate for themselves.
Case managers also take into consideration the client’s values, cultural and religious beliefs when working with them. They must take into consideration any relevant state and federal laws, current best practice guidelines, and health insurance plan requirements and obligations. Documentation is expected at every level of case management as it is in most health service environments. This creates a record for the safety, well being, and legal protection of both the case manager and the client.
The roles and responsibilities of a case manager can be boiled down to a single word: coordination. These skilled professionals act as the intermediaries between stakeholders and health care providers to put clients in the best possible position for success.
The first level of case management - intake - is the foundation for all other steps that follow. In this step, as much information as possible is gathered with an eye toward creating an accurate picture of the client’s current situation. This information is provided by the client and at this stage, the client’s needs are made expressly clear.
Let’s dive in a bit more on what happens in this stage of case management.
The information that is gathered at the first level, Intake, begins to organize and take form in level two - needs assessment. This is level, the case manager assesses all of the information at their disposal and develops an understanding with the client about what their needs and goals are what the road may look like to achieving those.
Here are some steps that are taken at this level:
In level three, very specific tasks and objectives are identified that will help the client move toward their goal. A plan is put together by the case manager that takes into account all of the information that was gathered in levels one and two. The plan is often subject to input from the client’s support system and their other health providers.
The steps involved with creating a service plan include:
The fourth level of case management is to evaluate the efficacy of the plan and to make sure that the client’s specific needs are being met by the case manager and the organization. The plan and metrics that were put into place in level three serve as the guides for monitoring and evaluating.
Today’s case managers have a wealth of tools at their disposal for effective case management. As we discussed earlier, managing the specific needs of multiple clients and keeping their plans, personal data, and notes organized and secure are basic expectations of the role. Thankfully, there is case management software that can help relieve much of this burden from the case manager leaving them with more time to spend focusing on their clients. PlanStreet’s Case Management software helps develop a workflow, manage client data, integrate data with existing systems, and configure dashboards to make the information the case manager needs readily available.
Documentation is a time-consuming aspect of a case manager’s role and utilizing case management software will result in a more organized and time-efficient case management process.
These four-level, when fleshed out and seen through to completion, are a roadmap to success for case managers. While each client’s specific needs and goals are unique to them, these levels and processes can be applied to every client. When combined with an empathetic case manager and a solid case management software tool, success is inevitable.
June 30, 2020