Creating clinical and economic "wins" through integrated case management: lessons for physicians and health system administrators

J Ambul Care Manage. 2011 Apr-Jun;34(2):140-51. doi: 10.1097/JAC.0b013e31820ef653.

Abstract

The 5% of patients using 50% of health resources commonly have interacting and persistent multimorbid illnesses; concurrent mental health problems; impaired social networks; and/or difficulties in accessing care through the health system. To improve outcomes in these patients, it is necessary to overcome clinical and nonclinical barriers that lead to poor health, treatment resistance, high health care cost, and disability. This article describes an innovative complexity-based and outcome-oriented approach using integrated case management. It helps treating physicians and health administrators understand how to incorporate value-based case managers to optimize care for complex patients while better utilizing resources.

MeSH terms

  • Case Management / economics*
  • Case Management / organization & administration*
  • Continuity of Patient Care
  • Delivery of Health Care, Integrated / standards*
  • Health Care Reform
  • Health Facility Administrators*
  • Humans
  • Outcome Assessment, Health Care
  • Patient-Centered Care
  • Physicians*
  • Quality of Health Care
  • Social Responsibility
  • United States
  • Workload