Integrated Care Management

Lower Health Costs and Improve Health Outcomes in Complex Patients through Integrated Care Management

Now that 30 million more Americans will be covered as a result of insurance reform legislation, health system stakeholders are looking for innovative ways to reverse high health care expenses associated with the current system’s fragmented care, especially for patients with health complexity, high health care service use, and functional impairment. Integrated case management (ICM), as a component of care management, provides an evaluation and care support process, which could incrementally change health outcomes and expense for the five percent of patients that use nearly half of health care dollars and that add to societal costs through lost productivity or participation in public programs. The principles of integrated case management can be adapted to other types of care management, such as disease management, assertive community treatment (ACT), disability management, so that a multi-service total management program using common work processes and documentation procedures can be supported through ICM work flows.

ICM targets patients with health complexity trapped in a siloed care delivery system. Unlike traditional care management approaches, integrated case managers are trained to assist with interdisciplinary conditions, including medical, mental health, and chemical dependence, as well as with social and health system barriers to health. They use a patient-centered, relationship-based approach during a comprehensive assessment of health complexity. Assessment findings are summarized in a grid through which the manager, the patient and/or caregiver, and the patient’s clinicians can decide on holistic goals and actions that will lead to “measured” clinical, functional, quality of life, satisfaction, and fiscal outcomes. ICM is a transformative interdisciplinary care management process that will become an integral part of care delivery reform as patient-centered medical homes, accountable care organizations, and other innovative care delivery programs are formulated.

ICM is more thoroughly described in the book: The Integrated Case Management Manual: Assisting Complex Patients Regain Physical and Mental Health.

If one or more of these describes your situation...

• You work for an employer trying to support health and productivity for its employees
• You work for a government agency tasked with managing a challenging and needy population with health and publicly sponsored services within a fixed budget
• You work for a health plan attempting to reduce health care claims while promoting member health, especially in chronically ill members and those with complex health conditions
• You work for a case or disease management vendor or supervise care management activities for a company, a health plan, or a care delivery system
• You work for a hospital and clinic system tasked with improving health outcomes for chronic, multimorbid, or complex patients and with lowering operating losses associated with their care

...Ways that Cartesian Solutions, Inc.™ can help

Cartesian Solutions, Inc.™ partners with the Case Management Society of America in offering formal training in CMSA software supported ICM for care/case managers, case management enrollment and support personnel, and physicians/medical directors. Cartesian Solutions, Inc.™ also offers customized ICM training for those who wish to incorporate ICM principles into their customized care management work processes. It also offers consultations in organizational realignment, as the next generation of care management, integrated case management, replaces traditional care management (see Table below). While the integrated case management approach is designed to target assistance to the most difficult and costly patients, its stratification and prioritization process facilitates adaptation and use as a system-wide management paradigm for professionals providing and coordinating the following care management services: case management, care coordination, assertive community treatment (ACT), disease management, disability management, workers’ compensation management, and health care coaching.

• Integrated Case Management Training
• Organizational Realignment

Cartesian Solutions, Inc.™
3004 Foxpoint Rd. - Burnsville, MN 55337
Phone: 952-426-1626 - Fax: 952-426-1200
E-mail: integration@cartesiansolutions.com