CMSA Today - Issue 4, 2015 - (Page 23)

CMSA's ICM Program Adult and Pediatric Integrated Case Management CMSA's Advanced Practice Value-Added Program BY ROGER KATHOL, MD, CPE S ince Adult Integrated Case Management (ICM) - a fullsystem advanced-practice form of case management - was introduced in 2008 at the Case Management Society of America (CMSA) Annual Conference & Expo, over 1,000 case managers have received Certificates of Completion in the program. Perhaps more importantly, over 10 regional and national health plans, care delivery systems, and management vendors that supply and/or support case management services have chosen to deploy adult ICM as a major component of their programs. Many are in the process of adding training for their case managers in pediatric ICM (PICM), the only specially developed training program and support system for children and youth about which we are aware, also provided by CMSA. In fact, some have made the ICM and PICM approach the primary case management support technique used in their companies. ICM and its child/youth counterpart, PICM, are relative newcomers to the field of case management. They were built to fill the need for a value-added approach to case management that was useable for complicated high-cost patients, members, employees, or enrollees (hereafter called patients) with combined medical and behavioral health conditions found in every community for whom cross-disciplinary service support and assistance could be delivered without having to transition the patient from one case manager to another. Further, they were built using a "health complexity" rather than "disease" platform so that those with uncommon illnesses and/ or presentations of an illness combination would be candidates for ICM assistance as readily as those with targeted common chronic medical and/or behavioral health conditions. Maintenance of the relationship between the patient and ICM manager was considered core to health improving and cost saving (i.e., value-added, assist, and support services). ICM and PICM differ from traditional case management in several important ways, including: Both require training of licensed or certified health professionals with assessment capabilities in ICM and/or PICM methodology to perform cross-disciplinary assist and support procedures consistent with core tenants of e4. This is true whether the health professionals come from medical or behavioral health backgrounds. 1 2 3 They use a scripted dialogue rather than a list of questions to complete a comprehensive biopsychosocial and health system (multi-domain) complexity assessment, using the color-coded adult and pediatric ICM-Complexity Assessment Grid (ICM-CAG [20-complexity items] and PICM-CAG [25 complexity items]) to allow the development of a relationship with the patient while a standardized evaluation is completed. Their CMSA software-supported ICM-CAG and PICM-CAG assessments allow development of a prioritized care plan that addresses cross-disciplinary clinical and non-clinical barriers to improvement both longitudinally and across treatment venues in collaboration with patients and their clinicians, until measured health stabilization and/or maximum benefit has occurred. Issue 4 * 2015 CMSA TODAY 23

Table of Contents for the Digital Edition of CMSA Today - Issue 4, 2015

Integrating Behavioral Health Services into Mainstream Medicine
Cleveland Clinic Integrated Care Model
The Importance of Collaboration
Adult and Pediatric Integrated Case Management
Corporate Collaboration

CMSA Today - Issue 4, 2015