case management

Home » Resources » Dictionary » Terms

Definition - What does case management mean?

Case management is a facet of the healthcare system designed to help patients receive efficient, fast, and optimal care in both acute hospital settings and in dealing with long-term chronic conditions. Case managers are accountable for developing and implementing a planned strategy charting a patient’s level of care and progress throughout recovery up to the time of a discharge release or condition resolution. Case management database systems provide an effective line of communication between case managers, physicians, nurses, social workers, external healthcare providers, and even insurance companies billed for services. With these measures in place, hospital staff members can work cooperatively in taking the best course of action for delivery of quality healthcare while shortening patient admissions. For companies dealing with time out of work and Workers' Compensation claims, having in-house case managers or third party case management can be an effective tool to help manage costs and shorten the time an employee is unable to work.

SureHire explains case management

Case management has a goal of preventing redundancies in care, reducing inefficiency, improving outcomes, reducing costs, and simplifying the process for all involved. Hospitals and insurance companies often offer their own case management programs for complex or long term injuries and illnesses. Companies sometimes employ in-house case managers, or contract with third party case managers, in order to better navigate liability claim issues and Workers' Compensation claims. By having a case manager follow a specific patient, that case manager can better streamline the process of care and catch any errors, omissions, or duplication of care that could both lengthen the healing process and increase costs for both the patient and the employer. These case managers can also help ease the paperwork delays because of better knowledge of the system than individuals might have that allows them to move things through the system without the errors or simple inefficiencies that can sometimes lead to significant delays and increased costs.

Subscribe to SureNews!

Get your Reasonable Suspicion Checklist! Join our community and get access to more resources like this! Emails are sent monthly, so no need to worry, we will not fill up your inbox.