Don’t Know Health Care Case Managers? Now’s the Time to Meet Them

Kelli Tungate is Executive Director at Seniorlink. 

"I'm a case manager"

"What's that, like, a social worker?" 

"Well..."

Health care case managers (known as Care Managers here at Seniorlink) often have to explain what it is they do for work when asked by folks from outside the world of health care. Many are registered nurses or licensed social workers, titles that help explain their background and skill set, but the case management aspect of their current role requires further explanation. There are already doctors, nurses, and social workers – so what's this other role in the mix? 

Someday soon I believe case managers won't have to do so much explaining. That's because they are at the vanguard of complex care management, a key segment of health care that is only growing in importance as the nation gets older. Debilitating diseases like Alzheimer's are becoming more prevalent while at the same time home- and community-based care options are multiplying – in fact, these options have taken a clear lead over traditional facility-based care in terms of spending by Medicaid, the nation's largest payer for long-term care. 

This shift means lots of people with complex care needs are living at home, leaving them and their families to deal with the often overwhelming work of managing life with a complex set of conditions. That’s where complex care management programs come in, providing a layer of support for families and patients as they navigate the health care system and the process of caregiving. It is case managers who are the glue that holds these programs together, ensuring they are effective for patients, family caregivers and payer/provider organizations alike. Case managers provide the human touch needed to build trust with family caregivers and patients who participate in these programs, which aim to improve health outcomes across broad populations.

Relationships and Care Management

We know that empathy is key in the health care conversation. Empathy cannot be automated, nor can it be easily replicated. It takes time to develop a relationship, and case managers across the country work hard to develop a level of trust with their clients that enables them to be more effective in their role. Whether through home visits, phone calls, or newer technologies that enable secure messaging through apps, the trust case managers develop through empathetic conversation is perhaps the most admirable aspect of their role, and one of the main reasons they are indispensable in complex care management. 

For an example, in programs like the intensive care model Seniorlink operates, CarePlus, Care Managers develop personal relationships with family caregivers, becoming a trusted sounding board for questions and advice about the many facets of caregiving, from managing medications to identifying changes in symptoms to practicing self care. Sometimes it's enough just for them to listen and empathize, letting the caregiver vent and feel supported. We consistently hear from family caregivers in the program how much of an impact their Care Managers have on their life and their experience with the program, how it has made them feel more confident in their role. 

But they are far more than just great conversationalists and trusted confidants. Their organizational skills, their judgment to determine what resources are needed, and their ability to marshal those resources are all marks of the unique set of traits and skills that are found in case managers. It's this combination of abilities that lead to Care Managers being instrumental in outcomes such as a 40% reduction in ER visits and 23% reduction in hospitalizations, as we found was the case in our CarePlus program. 

This week, on the occasion of National Case Management Week, I hope you will join me in celebrating case managers for all they do to improve care for the most vulnerable and complex populations.