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.

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.

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.

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 People use slow and outdated administrative systems, leading to overlap, repetition, redundancy and delays in understanding the clinical picture and providing the most efficient and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 contr?le est une stratégie nécessaire au renouvellement de cette confiance afin d'assurer une qualité attendue.

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.

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.

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.

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.

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.

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.