We have all been in same place at one time or another. You or someone important in your life has just been diagnosed with a serious condition and have to deal with the consequences and some major decisions need to be made before and during the treatment. In the event it can be difficult to know what decision to make without the right information and guidance. That’s where personal Medical Case Management services step in. Medical Case Management provides the latest, evidence-based information and guidance on the quality of care offered by leading hospitals and doctors, coupled with on-going support and supervision of the treatment.

What is Medical Case Management?

Medical Case Management is a service delivery approach and provides comprehensive care. Case management’s potential is only beginning to be explored as patients and health insurance companies continue to search for ways to contain cost while retaining quality.

“Medical Case Management is a collaborative process of assessment, recommending, planning, coordinating and implementing multi-disciplinary medical services to promote quality and cost effective outcomes and to achieve the best possible treatment and rehabilitation”.

Role of the Case Manager:

Medical Case Management services ensure that patients receive the appropriate medical care while maximizing cost savings. The Case Manager plays an important role in the process. He acts as an advocate for the patient. He coordinates care for medical procedures, suggests treatment options and
monitors on-going medical treatment. It begins with the evaluation and reassessment of the patient’s medical condition, usually with the revision of laboratory and radiology tests. Then, once the best course of action has been decided, the case management team will coordinate medical resources and develop and implement an all-encompassing plan of care.

Throughout this process each individual’s progress is carefully monitored and constant communication between the case management team and the patient ensures that all healthcare needs are being met to ensure on-going quality care.

Objectives of Medical Case Management:

• Focus on the patient and outcome of care
• Involve the patient in the development of the care plan
• Focus on full spectrum of patient’s needs thus identifying patient’s comprehensive needs
• Provide information about resources available to the patients
• Provide guidance as to how to appropriately access these resources
• Assisting patients in recognizing the usefulness or limitations of services
• Negotiating with providers and payers obtaining diverse services with controlled costs
• Optimizing and providing quality, cost-effective care across the continuum

Benefits of Medical Case Management:

• Help patients to take ownership of their health
• Provide meaningful support and trusted guidance
• Deliver timely and relevant communications
• Educate and empower patients along the treatment process
• Provide personalized care to Improve treatment quality
• Managed care leads to improved treatment outcomes
• Decrease health care costs and realize cost savings with personalized care
• Enhance member experience