Care Coordination in Medical Homes, Accountable Care Systems Forecasts Pivotal Role For Case Managers

Two new issue briefs from Commission for Case Manager Certification spotlight trends in new care models, value of case management credential

MOUNT LAUREL, N.J., June 8 /PRNewswire-USNewswire/ --Two new issue briefs explore the value of case manager certification as an indicator of quality and the role case managers will play in emerging team-based health care delivery models. The issue briefs were released today by the Commission for Case Manager Certification (CCMC), the first and largest nationally accredited organization that certifies case managers.  

Over the past decade, two models of care delivery -- the patient centered medical home (PCMH) and accountable care organizations (ACOs) -- have emerged as promising mechanisms to eliminate fragmentation and “connect the dots” through a common structural element: care coordination. In an article in this month's health policy journal Health Affairs, the Obama White House pegged care coordination as one of four elements critical for creating value in the PCMH and necessary for developing a scalable model that can expand to meet the nation's primary care needs.

In the CCMC brief, Care Coordination: Case Managers "Connect the Dots" in New Delivery Models, Geisinger Health Plan's Janet Tomcavage, RN, MSN links her program's case managers as "one of the keys to success for the medical home."  Geisinger's ProvenHealth Navigator(sm) program, a nationally-recognized medical home success story, uses 61 "embedded case managers" at 37 practice sites, coordinating care for some 20,000 Medicare Advantage members. Subject matter expert Michael B. Garrett, MS, CCM, vice president of business development for Seattle-based Qualis Health, also lends his voice to the issue brief as he discusses his organization's community health center medical home project.

The second issue brief, Growing Trend: Case Management Certification Desired—and Paid For--by More Employers explores the employer's view of professionalism in the case management industry and the use of certification as a quality indicator.  The genesis of the issue brief was a key finding of CCMC's 2009 Role & Functions Survey of nearly 7,000 case managers, which found that a growing number of employers require case management certification (36 percent, compared to 26 percent in 2004) and more employers offer additional compensation for certification (27 percent in 2009 compared to 20 percent in 2004).  

Lisa Woodring, LSCSW, LCSW, CCM, RN offers her experience in earning the case management credential in this brief. Sandy Weiderquist, RN, director of care management for Blue Cross Blue Shield of Kansas City and a 20-year veteran of case management, also brings subject matter expertise to the brief.

"The role of case manager has long been recognized by insurers, hospitals and other large organizations as vital to guide patients towards better coordinated care, but our profile is rising as care coordination takes hold in more ambulatory care settings," said Jolynne "Jo" Carter, BSN, RN, CCM, past chair of the CCMC. "Our survey and these issue briefs underscore the essential value of case manager certification to the quality equation as organizations expand their care coordination programs and seek leadership to set higher goals for patient safety and improved patient outcomes."

In late 2009, CCMC surveyed nearly 30,000 case managers and analyzed the results from 6,909 completed surveys to create a detailed profile of the role of case managers today and the functions they perform across care settings.  The survey, fielded every five years, is primarily designed to inform CCMC's certification examination process, but it also offers a look into current trends in case management, the skill set used in the field and the knowledge necessary to operate in today's rapidly changing environment.  The results of the survey will be co-presented June 10 at the Case Management Society of America's annual conference by Carter and study researcher Hussein Tahan, DNSc, RN, executive director of international health services for New York-Presbyterian Hospital.

To access the issue briefs, go to http://www.ccmcertification.org/secondary.php?section=Media_Room#role_and_function.

About CCMC

The Commission for Case Manager Certification is the first and largest nationally accredited organization that certifies case managers.  The CCMC is a nonprofit, volunteer organization that oversees the process of case manager certification with its CCM® credential.  CCMC is positioned as the most active and prestigious certification organization supporting the case management industry.  For more information, visit www.ccmcertification.org.

SOURCE Commission for Case Manager Certification