What is Care Management?
Care management is a team-based, patient-centered approach to care delivery. It is designed to assist patients and their caregivers in managing medical conditions more effectively.1 Care management involves a range of activities that help achieve wellness and improve coordination of care, while providing cost effective and non-duplicative services. Implementing care management strategies enhances care quality, improves health outcomes, and contributes to efforts to control health care costs.2 Care management is increasingly viewed as a key area for financial and staff resource investment as well as a strategy for succeeding in a value-based care environment.3
Care Management Readiness Assessment Guide
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The MHCC developed an interactive tool to help ambulatory practices assess their readiness to implement a care management program. The Care Management Readiness Assessment (CMRA) guide includes key program design considerations and other useful information about a care manager’s role and responsibilities. About 65 care management resources are referenced to support care management program development. To get started, take the CMRA practice self-assessment questionnaire.
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Resources
Centers for Medicare & Medicaid Services (CMS) Care Management
Provides resources for behavioral health integration, advance care planning, chronic, and transitional care management
FindHelp.Org
A free comprehensive search tool that streamlines care management and helps providers connect patients to social services in their area
HIPAA and Health Plans – Uses and Disclosures for Care Coordination and Continuity of Care
Answers to frequently asked questions related to HIPAA and sharing patient data for care coordination
AHRQ Care Management Implementation Guide
A guide for practices considering care management implementation
1. AHRQ, Care Management: Implications for Medical Practice, Health Policy, and Health Services Research, August 2018. Available here.
2. lbid.
3. Marcotte, L. M., & Liao, J. M. (2020). What we talk about when we talk about care management. The American Journal of Managed Care. Available here.