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Essay / Research Paper Abstract
A 3 page paper which examines the use of case management in managed care. Bibliography lists 2 sources.
Page Count:
3 pages (~225 words per page)
File: JR7_RAcscsm.rtf
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Unformatted sample text from the term paper:
the information pertaining to the individual. As such many have been turning to case management as it pertains to managed care. The following paper examines two different articles, discussing what
they have to say about utilizing case management for managed care. Case Management and Managed Care The first article is Using case management systems to integrate clinical and
financial data by Cindy Dullea and Catherine Fields. While written 10 years ago it is an article that is still just as relevant as it was then, as this sort
of topic may have new approaches but the basic notions of case management and managed care remain the same at their foundation. The authors note that, "Effective case management systems
can help caregivers track clinical and financial information; match appropriate resources to patient needs; and analyze populations to identify risk, enhance adherence to clinical guidelines, and understand provider treatment profiles"
(Dullea; Fields, 1998). They indicate that in the past, or in general, health care professionals and the subject of managed care has been handled through healthcare information systems which
were designed to offer information and assist in the generating of claims as well as assisting in supporting collection actions (Dullea; Fields, 1998). And, while this approach may help some,
the caregiver needs other information, information that is clinical "for patients or covered members from all segments of integrated delivery systems" (Dullea; Fields, 1998). The traditional method, which clearly involves
things like insurance and economic concerns, possesses many "walls" that interfere with a caregiver actually getting enough information to help and case management is more diverse, offers more information and
presents the caregiver with "a system of patient assessment, treatment planning, referral, and follow-up that ensures the provision of comprehensive and continuous care" (Dullea; Fields, 1998). The second article is
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