2017 Healthcare Benchmarks: Case Management in the United States - Product Image

2017 Healthcare Benchmarks: Case Management in the United States

  • ID: 4410039
  • Report
  • 50 pages
  • Healthcare Intelligence Network
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At the point of care or behind the scenes, care coordination by healthcare case managers helps to elevate clinical, quality and financial outcomes in population health management and chronic care, the all-important hallmarks of value-based care.

2017 Healthcare Benchmarks: Case Management provides actionable information from 78 healthcare organizations on the role of case management in the healthcare continuum, from targeted populations and conditions to the advantages and challenges of embedded case management  to CM hiring and evaluation standards. Assessment of case management ROI and impact on key care components are also provided.

This fifth comprehensive analysis of healthcare case management trends delivers 50 pages of newly collected metrics and measures on current and planned case management initiatives, presented in dozens of easy-to-follow graphs and tables.

This all-new data is derived from responses to the fifth Case Management Survey conducted in July 2017.

New in the 2017 Edition: This all-new report contains the following new data:

  • Percentage of case management programs targeting Medicaid-Medicare dual eligibles;
  • Prevalence of hybrid case management work locations (mix of primary care office, home, hospital, etc.)
  • Challenges related to integration of embedded case manager on care team;
  • Case management responsibilities in chronic care management;
  • Frequency of social determinants of health screening by case managers;
  • Use of telehealth and remote monitoring in CM-patient interactions;
  • Quality measures as CM evaluation metrics; and
  • Poll results: can the costs of patient-facing technologies (e.g. wearables, mobile apps, remote monitoring) be recouped through improved patient outcomes?

2017 Healthcare Benchmarks: Case Management also documents in respondents' own words frank feedback on their most rewarding patient interactions, advice for newly hired case managers, successful case management interventions, tools and workflows, notable improvements resulting from case management interventions, and more.

This report provides all-new expanded metrics from overall respondents as well as a deeper data dive into hospital and health plan sector responses on:

  • Current and planned healthcare case management programs;
  • Populations and conditions targeted by case management efforts;
  • Strategies for identifying and stratifying individuals for case management;
  • Program components and CM tasks;
  • CM-patient interaction modes, including technologies and home visits;
  • Case manager work locations and colocation/embedding trends and associated challenges;
  • Preferred education levels and certifications and average case manager case loads;
  • Metrics used to evaluate case management performance and program impact;
  • Key barriers to case management and resistance to launching of programs in this area;
  • The impact of healthcare case management on healthcare utilization, member/patient satisfaction, ROI and other key indicators;
  • The complete July 2017 Healthcare Case Management survey tool;
  • and much more.

This industry snapshot is enhanced with commentary from industry thought leaders who have shared case management innovations over the last year.

Healthcare organizations will benefit from these performance and utilization metrics to evaluate, plan and retool case management programs.

The 50-page 2017 Healthcare Benchmarks: Case Management provides continuous qualitative data on industry trends. Healthcare Benchmark members receive a continuous stream of trends data they can parse to assess strengths, weaknesses and opportunities, compare organizational performance with that of their peers, and identify best practices.

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Chapter 1: About the Author

Chapter 2: Executive Summary
Survey Highlights

Chapter 3: Key Findings
Program Components
Results and ROI
Most Rewarding Case Manager-Patient Interactions

Chapter 4: About the Survey

Chapter 5: Respondent Demographics

Chapter 6: Using This Report

Chapter 7: Responses by Sector
The Hospital/Health System Perspective
The Health Plan Perspective

Chapter 8: Respondents in Their Own Words
Most Rewarding CM-Patient Interactions
Improvements and Innovations from Colocated Case Management
Advice for Newly Hired CMs
Most Effective Tools, Protocols and Workflows
Most Important CM Program Component
Final CM Comments

Chapter 9: Conclusion

Chapter 10: Responses to Questions

List of Figures
Figure 1: All - Case Manager Utilization
Figure 3: All - Targeted Populations
Figure 4: All - Targeted Conditions
Figure 5: All - Patient Identification for CM 
Figure 6: All - Colocated Case Management
Figure 7: All - Future Colocated Case Management
Figure 8: All - Care Sites for Colocated CM
Figure 9: All - Top Colocated CM Challenges
Figure 10: All - Top Colocated CM Benefits
Figure 11: All - Typical CM Duties
Figure 12: All - Top CM-Patient Interactions
Figure 13: All - Average CM Caseload
Figure 14: All - Preferred CM Education Level
Figure 15: All - Additional CM Certifications
Figure 16: All - Factors in CM Performance
Figure 17: All - CM Impact
Figure 18: All - CM ROI
Figure 19: All - CM ROI from Wearables
Figure 20: All - Organization Type
Figure 21: Hospitals - Case Manager Utilization
Figure 22: Hospitals - Future CM Utilization
Figure 23: Hospitals - Targeted Populations
Figure 24: Hospitals - Targeted Conditions
Figure 25: Hospitals - Patient Identification for CM
Figure 26: Hospitals - Colocated Case Management  
Figure 27: Hospitals - Future Colocated Case Management
Figure 28: Hospitals - Care Sites for Colocated CM
Figure 29: Hospitals - Top Colocated CM Challenges
Figure 30: Hospitals - Top Colocated CM Benefits 
Figure 31: Hospitals - Typical CM Duties
Figure 32: Hospitals - Top CM-Patient Interactions
Figure 33: Hospitals - Average CM Caseload
Figure 34: Hospitals - Preferred CM Education Level
Figure 35: Hospitals - Additional CM Certifications 
Figure 36: Hospitals - Factors in CM Performance
Figure 37: Hospitals - CM Impact
Figure 38: Hospitals - CM ROI
Figure 39: Hospitals - CM ROI from Wearables
Figure 40: Health Plans - Case Manager Utilization
Figure 41: Health Plans - Future CM Utilization
Figure 42: Health Plans - Targeted Populations
Figure 43: Health Plans - Targeted Conditions
Figure 44: Health Plans - Patient Identification for CM
Figure 45: Health Plans - Colocated Case Management
Figure 46: Health Plans - Future Colocated Case Management
Figure 47: Health Plans - Care Sites for Colocated CM
Figure 48: Health Plans - Top Colocated CM Challenges
Figure 49: Health Plans - Top Colocated CM Benefits
Figure 50: Health Plans - Typical CM Duties
Figure 51: Health Plans - Top CM-Patient Interactions
Figure 52: Health Plans - Average CM Caseload
Figure 53: Health Plans - Preferred CM Education Level
Figure 54: Health Plans - Additional CM Certifications
Figure 55: Health Plans - Factors in CM Performance
Figure 56: Health Plans - CM Impact
Figure 57: Health Plans - CM ROI
Figure 58: Health Plans - CM ROI from Wearables

Appendix A: 2017 Healthcare Case Management Survey Tool

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In this comprehensive analysis of Healthcare Case Management, 78 healthcare  organizations weigh in on the role of case management in the healthcare  continuum, from targeted populations and conditions to the advantages and challenges of embedded case management to case management hiring and evaluation standards, via responses to a July 2017 survey.

Advice for newly hired case managers: “Don’t become overwhelmed by all that needs to be learned. Strive for sure and steady progress in gaining the knowledge needed.”
Hospital/Health System

“[My most rewarding interaction was] seeing a patient’s face when I was able to successfully acquire their medications for them at no cost. It was a look of astonishment and disbelief. They were brought to tears.”
Health Plan

“More time to resolve social issues, improve compliance and reduce ED   utilization [are advantages of embedded case management].”
Hospital/Health System

“ Case managers get better results when they are able to connect with members face to face. The connection is better between the two.”
Health Plan

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