Case Management Models: Best Practices for Health Systems and ACOs, Second Edition
Karen Zander, RN, MS, CMAC, FAANThe role of case management in healthcare settings is continuously evolving to meet the needs of patients and manage the quality, financial, and legal risks health systems and accountable care organizations (ACO) face. Case Management Models: Best Practices for Health Systems and ACOs offers insight into how to structure case management models across the continuum of care to address these needs and risks. Definitions and rationale for fundamental models, including dyad and triad, are provided to illustrate the needed resources and recommended structure. Guidance on case management deliverables and outcomes is also included to demonstrate the value of case management.
This book explains the differences between case management and social work and the ways in which case management functions have evolved over time. Rationale for providing case management services in health systems and ACOs is also included along with suggestions for case management reporting structures. Whether your healthcare organization has an existing or developing case management department, this resource can help you select an appropriate model and seek staff with skills best suited to help you reach your goals.
This book will help you:
- Describe how case management professionals are accountable for deliverables
- Determine which patients and families need case/care management across the continuum
- Decipher how many social workers and RN FTEs are needed at each level of care
- Explain how to use cost-benefit analysis to identify the best model for an organization
- Discuss the various ways of classifying case management models used in health systems
- Discuss how case management functions have evolved
- Describe the precursors and rationale for health systems to establish case management services
- Identify the seven fundamental components of case management models
About the Author: Karen Zander, RN, MS, CMAC, FAAN, president and CEO of The Center for Case Management in Wellesley, Massachusetts, has more than 40 years of healthcare experience. In this role, she serves as a consultant and educator to hospitals, physicians, healthcare systems, and software, pharmaceutical, and consulting companies worldwide for the development of tools, roles, and systems to support provider-side control of cost and quality.
Zander previously was associated with New England Medical Center Hospitals (now Tufts Medical Center), where she served in multiple roles, including organizational development specialist in the nursing department, director of consultation in the Center for Nursing Case Management, inpatient/day hospital psychiatric service nurse leader, and staff education instructor.
