Working with Integrated Case Managers to Improve Health Outcomes and Reduce High Cost in Patients with Health Complexity

Abstract

Over the last four decades, the US health care system has changed dramatically. Consequently, medically complex and high-cost patients and their doctors are at significantly greater risk for miscommunication regarding treatment and medication regimes. Knowing how to identify, assess, and implement actions that address health complexity can offer significant support to patients, families, and other caregivers facing challenges presented by a complicated health care system. Psychiatrists can be key contributors to total health outcome improvement and cost reduction in patients with health complexity, but can do this best if they learn to coordinate their clinical skills with the assist functions of integrated case managers. This chapter provides an overview of a collaborative interdisciplinary model of care in which psychiatrists with other treating clinicians utilize the support services of integrated nurse and/or social worker case managers trained to help patients with biopsychosocial and health system barriers to improvement, i.e., those with health complexity. Physicians working with trained case managers can improve care coordination, transitions of care, patient safety, health outcomes, and cost.

Ms. Lattimer is the Executive Director of The Case Management Society of America (CMSA), a 12,000-member organization of primarily nurses and social workers that supports the development, implementation, growth, and improvement of value-added case management programs and professionals throughout the health system.