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The Case Management process encompasses communication and facilitates care along a continuum through effective resource coordination. The goals of Case Management include the achievement of optimal health, access to care and appropriate utilization of resources, balanced with the patient's right to self determination.
Medical case management may include, but is not limited to, care assessment, including personal interview with the injured employee, and assistance in developing, implementing and coordinating a medical care plan with health care providers, as well as the employee and his/her family and evaluation of treatment results.
Case management has alternatively been known as "service coordination" or "care coordination" since the late 1980s. Care coordination is defined by NASW as "a client-centered, assessment based, interdisciplinary approach to integrating health care and psychosocial support services in which a care coordinator develops and implements a ...
The case management restrictions must not "substantially impair access" to primary care services of "adequate quality where medically necessary"; and; The case management restrictions must be "cost effective". [2] In their earliest forms, PCCM programs closely resembled traditional fee-for-service Medicaid than managed care.
Case management (mental health), a specific approach for the coordination of community mental health services; Case management (US health system), a specific term used in the health care system of the United States of America; Medical case management, a general term referring to the facilitation of treatment plans to assure the appropriate ...
According to the American Association on Mental Retardation (1994) "Case Management (service coordination) is an ongoing process that consists of the assessment of wants and needs, planning, locating and securing supports and services, monitoring and follow-along. The individual or family is the defining force of this service coordination process."
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Health Care Service Corporation is the licensee of the Blue Cross and Blue Shield Association for five states. It concentrates its operations in Illinois, Montana, New Mexico, Oklahoma, and Texas. HCSC is the fifth-largest health insurer in the US overall and employs more than 23,000 people. As of 2019, it was noted to be the third-largest ...