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Medical case management is a collaborative process that facilitates recommended treatment plans to assure the appropriate medical care is provided to disabled, ill or injured individuals. It is a role frequently overseen by patient advocates .
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.
Primary Care Case Management (PCCM) is a system of managed care in the US used by state Medicaid agencies, in which a primary care provider is responsible for approving and monitoring the care of enrolled Medicaid beneficiaries, typically for a small monthly case management fee in addition to fee-for-service reimbursement for treatment. [1]
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 medical care is provided to disabled, ill or injured individuals; Legal case management, a set of management ...
In short, a medical social worker provides services in three domains: intake and psychosocial assessment, case management and supportive therapy, and discharge planning and ongoing care that extends after hospitalization. They are also involved in patient and staff education, as well as with policy research for health programs. [4]
In the United States, disease management is a large industry with many vendors. Major disease management organizations based on revenues and other criteria [5] [6] include Accordant (a subsidiary of Caremark), Alere (now including ParadigmHealth and Matria Healthcare), [7] Caremark (excluding its Accordant subsidiary), Evercare, Health Dialog, Healthways, LifeMasters (now part of StayWell ...
A medical emergency is an acute injury or illness that poses an immediate risk to a person's life or long-term health, sometimes referred to as a situation risking "life or limb". These emergencies may require assistance from another, qualified person, as some of these emergencies, such as cardiovascular (heart), respiratory, and ...
Case management is the coordination of community-based services by a professional or team to provide quality mental health care customized accordingly to individual patients' setbacks or persistent challenges and aid them to their recovery.