What are the most effective cost-saving strategies for case management?

The first step should be to clarify the goal and objective of case management as a practice, in other words its definition of success. In an environment of value-based care, the goal of case management should be the quality of care, provider performance and patient experience. Without a clear direction, case management will often get lost in the weeds and become time consuming. Leveraging technology such as AI could make case management much more effective in achieving the desired outcomes.

Clients and families often choose to neglect our professional advice to hire a care manager. However, when they see that their efforts have not produced the desired results or they feel ill informed to make a decision they realize that they have wasted time, money and have created more stress for themselves and for their aging loved one. Care managers offer 3rd party unbiased education and information that can help guide the client and their support systems into more informed decision making. Having a local representative when an unexpected health crisis occurs can help out of town families find comfort that their loved ones current needs are being met saving them lost wages and unnecessary trips home to "check" on things.

We often get caught up in doing extensive assessments when people are coming in to put out a fire. Supporting clients with the ‘fire’ will often get them back in your office to complete a comprehensive assessment. I will often use brief solution-focused responses to engage the client. For example, if you were to leave here today and you were happy, you came, what would need to happen for you to know it wasn’t a waste of your time? We then work through what needs to happen, and often, I could complete the assessment without the client in the room just with that question.

As a neuropsychologist I usually act as clinical lead for most of the cases I work with. Over the years I see so much wastage due to incomplete and inefficient assessment and tracking processes. People use slow and outdated administrative systems, leading to overlap, repetition, redundancy and delays in understanding the clinical picture and providing the most efficient and targeted intervention. Ultimately this is what lead me to develop @GoalManager, my rehab planning and outcome tracking and reporting app.

La confiance est un concept éducatif. Dans ce processus, le contrôle est une stratégie nécessaire au renouvellement de cette confiance afin d'assurer une qualité attendue.

Do you have a relationship with this person? Do you know this person? Stop and ask the person what they feel is a priority? Ask the person to set their own goals and identify those people that play a significant role in their life that can help? Case management is about supporting the person in an empowered way so that they can make informed choices and direct what they want to happen!

Case management encompasses the "whole" person, not just the disease, medications, psychosocial or family support. Combining all aspects of this patients care needs will bring the center of care back to the wholeness that is imperative in order to treat effectively. Encourage the patient to state their own goals, so that the team has a realistic path to follow. If the patient isn't engaged in their own care, the team will fail and the outcomes will be unfavorable. Bringing the support of their family into the care plan enhances the success of the entire team. Patients heal faster and with greater outcomes in their own homes where they feel safe and loved. Educating the patient and family will add to the success after discharge.

One thing i found helpful is (Get to know the Client). Learn about the history, their background, History, Preferences, their goals and current state. knowing all that will paint the picture of their current state of resources. once the whole picture is clear. we can start browsing the main needs and all the available tools to start planning. we need to also prioritize the Goals and Needs.

One thing that can useful is to involve the client to plan an individualized care. One may identify the client's need, but priorizing them needs active involvement of the client for his/her cooperation.

Coordinating and integrating care involves establishing robust communication channels, utilizing shared electronic health records, fostering collaboration through team meetings, and appointing a care coordinator for oversight. Patient involvement and informed decision-making are crucial, supported by standardized protocols and workflows. Continuous evaluation ensures ongoing improvement in the seamless integration of care across various providers and settings.

The biggest opportunity in coordinating care lies in closing care gaps and staying on top of transitions in care. Using technology-based tools and resources and by working very closely with our care delivery colleagues, we can create pilots, initiatives and programs that have multiple stakeholders (health care systems, insurance, patient groups), with ultimate goals of improving access, quality and cost of care.

I can’t believe how with all the technology available we still can’t do this. We still rely on discharge summaries collated by junior staff when a patient leaves hospital. They often arrive weeks after the discharge. Community based staff - aged care, community nursing , pharmacists, general practitioners are unable to look into the patients hospital records to clarify medications, wound care etc The silos in health remain and appear to be protected. I have been working in the community for over 30 years and the same problems exist today as did when I started. There are pockets of innovation but they often die when there is a change of government. The rhetoric about putting the patient at the centre of care is everywhere.

Important part of case management is identifying a lead agency to be able to keep the goals and needs of the families on track and stop case work drift from occurring

Doing this allows not only the case manager but he client to see where the supports and and where they need to fill the gaps. Working collaboratively over all care networks will benifit.

Coordinating care should be facilitated by a neutral party to the direct care providers and include a team of both clinical, non-clinical, and natural supports within the client’s home community. Evidence suggests the needs/strengths approach is necessary to improve outcomes for clients. The team must build a working rapport with the client and their supports, balance the team member perspectives to create an accurate needs and strengths list, and help families develop a sense of hope and genuine healing to sustain outcomes.

Coordinating and integrated care plans is a step towards the delivery of care with a patient centred focused. This helps to reduce any delays in providing for the clients and best support the client with limited gaps between services, this integrated care plan benefits those who are vulnerable and in need.

Two ways communication is required for the effective and efficient for coordinating and integration. A feed back mechanism is required

Over my lifetime, this is one of the areas that is often neglected and overlooked. The same lab test might be ordered two days in a row by different physicians. There are often too many medications ordered as any time we have seven or more medications being given, the body is creating new combinations inside the body. No wonder there are side effects, but of what? Medications need to be prioritized and decreased. Pain could be controlled better if there was a range of narcotic dose maximum over 4 hours, but also allow a choice of routes to decrease the amount and transfer to a non narcotic as early as possible. But, and I say butt, at the exact same time any narcotic is ordered, the gut will slow down. So begin a bowel action order.

Coordinating and integrating care is reduces duplication, improves communication, and streamlines the delivery of services. By coordinating care across multiple providers and organizations, case managers can eliminate unnecessary tests, procedures, and services, thereby reducing healthcare costs. Additionally, integrating care ensures that services are delivered in a cohesive and holistic manner, addressing all aspects of an individual's needs and reducing fragmented and costly care. By optimizing resource utilization and promoting better health outcomes, coordinated and integrated care helps control costs while improving the overall quality of care provided.

I would argue that educating and empowering clients is not only the most cost effective strategy, but without it the rest of the strategies are pointless. Unless the client agrees to take an active role in their own care little can be done to truly help the client. Once however they are willing to be an active participant in their treatment, anything is possible.

Agree with Larry. If people are not educated on their choices then they have no choices. You don't know what you don't know.

Utilizing the precepts of Motivational Interviewing in this process is critical to empowering the client. You allow them to identify their own priorities and realistic goals. This process has proven reliable and valid. When the client engages, they OWN it. They will then be hungry to learn and you can provide them with education that meets their needs.

From my perspective this is the most important factor, to work with the client to not only educate them about the full rehabilitation process, but to assess and consider the client’s own engagement and motivation to enable them to ultimately be in charge of their own recovery journey.

I completely agree with Larry.until you get the pts buy in and willingness to participate it makes no sense to go any further.

I am a big fan of providing psycho-educational programs for clients individually or in groups. We will promote mental health and well-being by engaging clients in the learning opportunities. However, we can not assume clients are blank slates; therefore, checking for their conceptualization of the problem in terms of context and content is crucial.

As case managers, empowering our clients through education is key. When clients understand how to navigate challenges, we break the cycle of repeated problems, like hospitalizations or legal issues. This not only improves outcomes but also saves resources by reducing the need for recurring interventions.

In my experience as case manager working with immigrants families this is for me the most important strategy. Of course all the rest are important but if you educate and empower ,provide the right resources and work with key partners that make a huge difference . I have been seen people who came with nothing having difficulties to communicate due language barrier and they are now very successful. You can’t do this work along you must have people who can support the work that you do !

In my experience as case manager working with immigrants families this is for me the most important strategy. Of course all the rest are important but if you educate and empower ,provide the right resources and work with key partners that make a huge difference . I have been seen people who came with nothing having difficulties to communicate due language barrier and they are now very successful. You can’t do this work along you must have people who can support the work that you do !

Engaging in informed and supported decision making when assisting in identifying goals for the client ensures they have all the information they need to make decisions on not only their goals but how to achieve them.

Using data and technology to monitor utilization, evaluate outcomes, and to track progress with productivity, helps to ensure resources are being allocated effectively. As trends are identified, new workflows can be initiated, or existing workflows updated, to appropriately reflect changing priorities.

In my practice, leveraging technology has been pivotal in optimizing case management, mitigating burnout, and enhancing client-centered focus. By incorporating tech solutions, my team redirected our energy from administrative tasks towards more impactful client engagement. Contrary to common belief, the implementation of tech tools often utilizes resources already allocated within the organization. Moreover, technology integration facilitates real-time data collection, enabling swift evaluation of our service model, thereby fostering improvements beneficial to clients, employees, and the overall business.

To leverage technology and data effectively, integrate electronic health records for streamlined information access, employ data analytics for insights into patient outcomes, and utilize telemedicine and mobile health apps to enhance care accessibility. Prioritize cybersecurity to protect sensitive data and ensure regular updates to stay current with technological advancements. This strategic use of technology optimizes healthcare processes, improves patient care, and enables informed, data-driven decision-making.

Technology is certainly helpful in case management, it helps with workflow, productivity and efficiency. However one downside is that often there is so much duplicated data in a chart that important things go unnoticed. Checkboxes are efficient but they can be missed. Programs can run algorithms it people are more than just data. Technology can help on the back end show trends but it still doesn’t show the value of case management, because it captures what happens like readmission, not what doesn’t unless all data is shared across medical and insurance.

It's important to invest in case management software,and implement robust case management software systems to streamline workflows, track progress, and improve data analysis. This can save significant time and effort in the long run.

Often case management (CM) providers focus on the direct service hours as an outcome metric. However, for short term CM, to be truly cost effective – we must develop, and monitor, outcomes achieved for the clients (example: obtaining food, clothing, Dental appt, etc.). Without this focus, we cannot truly measure “effectiveness” of services. Technology can help capture this information, which can then be used by management to identify team members who are effective and replicate their actions. As in telehealth services, technology can also be applied to case management to achieve the same levels of effectiveness, while being more efficient. Technology, combined with a focus on outcomes, creates more cost-effective CM services.

The use of technology and data has made life easier with a click of one button. You can access a variety of important information right there and very convenient as well. With a click of a button can send important information and thatbmakea work efficient quick and hassel free. The downside to it is that when the system I'd won then there is the issue to access the data and information so keep a hard file is also handy.

Technology and data are crucial to success in case management. You must identify and prioritize your target populations. You can begin with the aggregate and move toward the specific, then isolating those at greatest risk. Programs can be developed for those specific groups, by disease process for example, and individuals can be specifically identified and targeted for intervention. Providers can also be assessed and identified this way to improve outcomes. Technology takes our work to a new level by making the process more efficient and more importantly more personal for the client.

Utilize technology and data to enhance time management skills. Date and Case Management is always evolving. Giving yourself the time to learn new skills and efficiently apply techniques. You need a workflow tailored to your strengths while maintaining company compliance.

To apply evidence-based practices, stay informed about current research, assess evidence quality, and collaborate with colleagues. Implement standardized protocols based on robust evidence, considering patient values. Engage in ongoing professional development to stay updated, and regularly evaluate outcomes for continuous improvement in the quality of care provided.

Using evidence based practices, such as Housing First drastically reduces the cost of people being homeless. In Silicon Valley the average yearly cost of homelessness per human is $100,000. Housing is a much cheaper option, mostly through decreasing the use of emergency services. Permanent housing provides far greater results in obtaining income, benefits, employment. vocational traing, and physical and mental health.

Evidence based practice is reliable and effective in supporting the client and managing your case. It has quality standards and proof that it works and that the system will support the implementation and process and its main focus / goal is to improve the client's outcomes. This practice helps in decision making and helps to make an informed decision and another benefit is that it has credibility.

Evidence-based practices (EBP) can help reduce healthcare costs by helping healthcare professionals choose the best diagnostic tests. This can reduce the financial burden of over-testing and false-positive results.

Applying evidence-based practices with proper resources adds value to the therapeutic work with the client. Psychotherapy is effective when the practitioner is well-informed about recent evidence-based techniques and outcome-based strategies. However, science should benefit everyone. Checking for client's feedback and monitoring the progress is part of an evidence-based approach. Therefore, integrating science into the client's culture and learning styles significantly helps a positive outcome.

Applying evidence-based practices ensures that interventions and treatments are based on proven effectiveness, reducing the risk of unnecessary or ineffective services. Evidence-based practices are supported by rigorous research and clinical evidence, indicating their positive impact on outcomes. By implementing these practices, case managers can avoid costly trial-and-error approaches and focus resources on interventions that have demonstrated effectiveness. This reduces the likelihood of wasted resources on ineffective or potentially harmful treatments. Implementing evidence-based practices also promotes standardized care protocols, which can lead to better coordination and streamlined delivery of services.

The best part about collaborating with peers is about learning best practices and new ways of handling tough case management issues. If we could chronicle a set of "best practices" about common case management practice areas taht would be simply wonderful for new and seasoned nurses and otehr clinicians.

Networking with other agencies allows for greater reosuce distribution and specialised supports to be put in place for families further addressing and supporting their needs. One agency cannot provide everything for families therefore linking with other services is vital

The goal to working with and/or using peers, in any capacity, is to increase engagement. For a case manager, networking with peers provides a forum to utilize one another’s experience to determine more efficacious interventions, thus decreasing stress/frustration and boosting the perceived self efficacy and satisfaction of employees. For clients, the productivity from this shared expertise increases the benefit of case management services, driving engagement and the likelihood of retention.

Collaborating and networking with peers involves proactive communication, mutual support, and knowledge exchange. Attend professional events, conferences, and workshops to establish connections. Utilize online platforms and forums to engage in discussions and share insights. Foster a culture of openness and collaboration within your workplace, encouraging team-based projects. Actively seek opportunities to contribute your expertise and be receptive to learning from others. Regularly communicate updates on shared projects and celebrate collective achievements. Building strong professional relationships enhances collaboration, enriches collective knowledge, and contributes to a supportive and interconnected professional network.

In my experience, I encouraged highly skilled nurses to share their patient assessments so that I could spend more time with cases that had less talented staff. It was helpful to visit cases at school sites as well because I could often see several cases in the same class or school, decreasing travel time & making myself accessible to the teachers & district for feedback.

Practicing collaboration and networking with peers may help resolve some staffing issues. When patients have better outcomes, the staff and providers will likely feel more pride in their work. This sense of purpose can be motivating making them feel happier and more fulfilled therefore reducing burnout. Collaborating with other healthcare professionals can help alleviate workloads and make space for emotional support as needed.

In Nebraska, I was involved in the Deaf/ Hard of Hearing Special Education Advisory Committee. It was comprised of educators, interpreters, regional program leaders, school administrators, college professors in the area of Deaf Education, etc. With everyone coming together, we all understood what was happening across the state, as well as the services and activities that were happening with students/ clients that we had in common with the people on the other side of the table in these meetings that we would not otherwise interact with. These meetings were very helpful for the success of our students/ clients.

In my view, collaboration and networking with peers is another vital strategy in case management, fostering a community of shared knowledge and resources that enhances the quality and effectiveness of client care across various sectors.

It is important to know your personal and professional limitations as a therapist. Not knowing this information can cause harm to your clients. Collaborating with peers and other professionals can prove to be the best option to assist and support your clients. To be an effective therapist I understand that it is my duty to build on my knowledge in the field of therapy. I am also required to keep up with the trends in my field. Because what I contribute to my profession is important.

When you collaborate with peers you can find resources for members that can have profound impacts not only on their care, but their social determinants of health. By looking at the whole person we are able to help lead to better health outcomes and more adherence to the plan of care.

I believe empowering the client should be at the forefront of the care plan development to organise what kind of care or services the client would like based on their health and physical ability. With the new aged care quality standards coming into play in July 2024, the target focus, where able, is to develop care plans that focus on reablement - to get the client doing things that they once could with assistance from allied health therapy support and services support to maintain a clean and safe living environment. Building a rapport with them at the beginning and understanding their expectations moving forward and then incorporating those ideas and facts into a management plan of devised services that work around the client.

Consider the context that case management is happening within. Are you case managing within a school, a community center, a hospital or a neighborhood? At Communities In Schools, our model pairs case management with site coordination within school environment. Site coordination captures strategies that have schoolwide, build culture and remove systemic barriers. The two have to be aligned and coordinated together. Case management is needed because the function of the main system is insufficient and poorly designed to meet the needs of all people. Taking the insights from case management to inform broader strategies helps to guard against growing case loads.

Another key perspective which appears to be missing from this discussion is the need for proactive monitoring and follow-up. The key aim of case management is to provide optimal outcome focused interventions and avoiding therapy drift. So regular communication by the case manager with the rehab client, the referring parties, treatment providers and any other stakeholders is crucial in achieving success in case management goals.

Resource Management is also important, - Optimize staffing levels - Cross-train staff - Leverage volunteers - Outsource non-core functions

The key missing in the answers above is the team you are working with. Case management, we have to develop ITP’s for each client utilising a full MDT. This is how treatment should be and in that space - where the team collaborates, trusts, listens, works together - allows for clear clinical guidelines to be met in each interaction. I would say in order to build this trust, the team need to work together, seamless communication and no ego. No matter what the degree, nor position, not title - every persons input will add value to the work we do with each individual client.

The need to effectively manage care for clients with complex needs or those from diverse populations requires training in topics like critical thinking, care planning, and motivational interviewing. Relationship building is another important strategy. Patients may believe a case manager’s singular goal is to reduce the cost to the health plan by any means possible, including by negatively impacting the patient’s outcomes. As a case manager it’s our responsibility to gain the trust of the patient as this is the only logical and realistic way of improving client outcomes and thus reducing healthcare costs in the long run.

One thing I have found important is to educate client about the situation and process involved to mitigate future incidents. It will not only help to reduce risks but also will help to prevent repetitive issues.

Continuous performance improvement measures and Transparency - Strong staff that you invest in will help consumers reach goals and gain independence. - Data that is related to purpose and impact; and that the staff understand and are supported for attainment of those targets - Helping staff understand personal, program, and organizational budgets- if we invest in X that means less for Y and vise versa so they relate their asks and efficiency to the bigger picture. The more staff understands the more they are invested.

In my experience it is critical to have lower case loads, to prevent a reactive interaction vs a proactive engagement. Squeaky wheel case management just isn't the quality we would want for the people we serve. Also... Pay the boots on the ground their value rather than a dictated amount.

I don’t see any discussion about selecting a health care agent or discussing the end of life for when it occurs. It will occur for all of us. It is most likely easier if other family members agree to participate too. If an entire family (maybe limit to 7 or 10 people at most). If they all hear each other’s voices, they will comprehend what is different or the same between various family members. If you speak with the patient first to help them gain control of their emotions but also their environment and assist them to describe the care wanted or to refuse by physicians.