Why Case Managers are Important in Healthcare

Case Managers play a key role in the healthcare process.  Without case managers, healthcare would be less efficient with patient care and direction.  In many ways, Case Managers are the glue that ties the healthcare process together and helps care become efficient, directed and expedient.  When there is a lack of case management, then patient care is negatively affected and the process of and direction of care can become disjointed and inefficient.  This is why so many healthcare facilities hire certified Case Managers to ensure that proper records and patient care are directed and handled in an efficient way.

Healthcare facilities, hospitals and nursing home facilities depend on case managers for a variety of reasons.  First and foremost, case managers are responsible for records that track the history and progress of each patient.  Case Managers collect information from primary care givers that help them identify past patient health history and medications.  In addition, besides gathering past records, Case Managers are responsible for monitoring current treatment as well as future treatment and follow up.  This requires a healthcare professional or nurse, who is well educated in the nuances of records and Case Management.  For any facility to offer the best patient care, record keeping is essential.

Second, Case Managers play a key role in coordination.  Case Managers are very much the glue that ties together past, present and possible future healthcare teams in the treatment of one patient.  During treatment, a patient may undergo various tests, be seen by various different healthcare professionals, and have various appointments at different facilities.  The Case Manager plays the role of coordinating different team members to ensure everyone is working for the same goal and not overlapping each other.  As a coordinator, Case Managers ensure each patient receives uniform care with a common goal of successful treatment.

Third, Case Managers ensure better patient outcomes.  Readmissions is a big problem for many hospitals.  Readmissions cost hospitals and other healthcare facilities millions of dollars each year and place them in poor ranking with government agencies and insurance companies.  It is essential through good coordinated care and proper patient tracking that patient outcomes after initial visits resolve health issues.  When health issues persist due to bad follow up care, or poor coordination, then hospitals and healthcare facilities stand to lose the most.  In Healthcare Case Management, it is essential that Case Managers ensure good follow up care for patients.  This involves follow up to ensure patients are taking the proper medicines, understand the importance of those medicines, and meet with proper follow up appointments and treatments.

Fourth, Case Managers play a big role in ensuring the proper collection of fees and bills by the hospital or medical facility within the financial aspect of healthcare.  This involves working with insurance companies and helping the patient understand payments and billing.  Case Managers work with the patient and insurance to the best of their ability to ensure the insurance company is billed properly and that the healthcare facility can collect on payments.  It also involves working with those within the billing department of healthcare facilities and giving them the guidance they may need to properly send out billing and invoices.

Summary

Within healthcare, it is important to have highly trained healthcare professionals who organize the process of patient care.  The Healthcare Case Manager plays the role of record keeper, organizer, coordinator, and financial liaison that glues everything together to ensure cohesion, direction, and optimal patient health outcomes.  Without their hard work and dedication, the healthcare sector would face disorganization, poor patient outcomes and large financial losses.   It is because of this that numerous hospitals, facilities and nursing homes have trained Case Managers on staff to handle these critically important duties within the facility.