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
Agency for Healthcare Research and Quality (AHRQ) Care Management Issue Brief
Highlights strategies to enhance care management programs
Centers for Medicare & Medicaid Services (CMS) Care Management
Provides resources for behavioral health integration, advance care planning, chronic, and transitional care management
CMS Chronic Care Management Toolkit
Includes key requirements and considerations for implementing a chronic 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.