CMSA Today - Issue 4, 2017 - 12

C U LT U R A L C O M P E T E N C E

CASE MANAGEMENT

AT THE HELM OF DIVERSE AMERICA
BY JOSE ALEJANDRO, PHD, RN-BC, MBA, CCM, ACM, FACHE, FAAN

M

artin Luther King, Jr.
was quoted in 1964 as
saying, "Of all the forms
of inequality, injustice
in health is the most
shocking and the most inhuman." Over
fifty years later, our society continues to
struggle with creating a healthcare system
that has the ability to meet the cultural
needs of the diverse people we serve. As
case managers, we are very familiar with
how social determinants impact care delivery
and wellness overall. As leaders, how can we
make a difference in our global community?
Leading in an environment of continuous
change is daunting and exhausting. Over the
continuum of care, the needs of the stakeholders we serve are constantly evolving. A
successful organization has a culture that
engages stakeholders, teams and our partners in embracing the organization's mission
and vision. As leaders, we need to apply key
learnings about how we can strengthen a
culture of learning within our organization.
We need to consider the question, "How
can we use a systems approach to reduce
gaps and fragmentation of care within an
ever-diversifying community?"
MELTING POT BECOMES LARGER
The non-Hispanic white population in the
United States is projected to peak at 199.6
million in 2024, with a decline of approximately 20.6 million by 2060. Hispanics
will see a significant boom in growth
from 53.3 million in 2012 to 128 million
in 2060. Hispanics will grow from one in
six to one in three by 2060. The black or
African-American population will see a slight
growth from 41.2 million to 61.8 million in
the same period. Asians will see a doubling
growth during the same period of time,
12

CMSA TODAY

Issue 4 * 2017

from 15.9 million to 34.4 million. The significance of this trend is that the younger
generations are predominately minorities. In
2060, non-Hispanic whites will account for
43 percent; Hispanics 31 percent; blacks 15
percent; Asians 8.2 percent and other 2.8
percent. Two or more races will account
for 6.4 percent of total population (United
States Census Bureau, 2012).
Diversity within healthcare disciplines,
such as case management, are not representative of current population trends.
Registered nurse demographics include
white 75.4 percent, black or AfricanAmerican 9.9 percent, Hispanic 4.8 percent,
Asian 3.6 percent and others 6.3 percent
(Minority Nurse, 2015). Social worker demographics include white 87 percent, black
or African-American five percent, Hispanic
two percent, Asian two percent and others
four percent (National Association of Social
Workers, 2003). As leaders, how can we
develop educational and career pathways
that support the development of a more
diverse workforce?
CHALLENGES
Three important factors that will continue to impact case management practice
include: managed care expansion, a growing

"We must persist in working
with other healthcare
professionals to promote a
transdisciplinary approach to
improve individual outcomes
and individual satisfaction while
addressing cultural differences."

elder population, and increasing numbers
of chronically complex individuals who are
maintaining an improved quality of life as
more innovative treatments and drugs are
developed (Commission for Case Manager
Certification, 2017). These factors are further
compounded by the lack of resources, limited mental health services throughout the
country and our changing demographics.
Our definition of "managed care" is transforming. As case managers, we are faced
with a dichotomy - managing care of the
individual and managing care of expanding groups of people across the continuum
of care. Payment mechanisms continue
to become more complex and chaotic.
In order to reduce care transition disruptions, we need to become more familiar
with how our continuum of care partners
are paid for the care that they provide and
the respective requirements and scrutiny of
oversight agencies.
As the size of our elder population
increases, we quickly have become aware
of the importance of strengthening our relationships across the continuum of care. It is
imperative that we consider how to effectively network with our peers and understand the diverse perspectives and needs
of our partners. How can our professional
association bridge the generations? How
can we demonstrate the value-add of the
case management professional?
Our global community continues to
develop innovative ways of providing more
complex and life-sustaining care. At the
same time, we are faced with balancing
the unique needs of the diverse individuals
we serve. Many times, case managers are
put into the untenable position of mediating
between the individual and the payer. Our
ability to critically think as reflective and



Table of Contents for the Digital Edition of CMSA Today - Issue 4, 2017

President’s Letter
Association News
CMSA Conference Supporters
CMSA Corporate Partners
Case Management at the Helm of Diverse America
Community Health Workers: A Key Role on the Collaborative Care Team
Ticket to Work: Strategies for Case Managers Who Face Work-Disrupting Disabilities
For Case Managers, Success Requires Mastering Today’s Challenges
Using a Patient Engagement Strategy to Help Care Managers Educate Patients at the Right Time—Before It’s Too Late
Index of Advertisers
CMSA Today - Issue 4, 2017 - Intro
CMSA Today - Issue 4, 2017 - cover1
CMSA Today - Issue 4, 2017 - cover2
CMSA Today - Issue 4, 2017 - 3
CMSA Today - Issue 4, 2017 - 4
CMSA Today - Issue 4, 2017 - 5
CMSA Today - Issue 4, 2017 - President’s Letter
CMSA Today - Issue 4, 2017 - 7
CMSA Today - Issue 4, 2017 - Association News
CMSA Today - Issue 4, 2017 - 9
CMSA Today - Issue 4, 2017 - CMSA Conference Supporters
CMSA Today - Issue 4, 2017 - CMSA Corporate Partners
CMSA Today - Issue 4, 2017 - Case Management at the Helm of Diverse America
CMSA Today - Issue 4, 2017 - 13
CMSA Today - Issue 4, 2017 - 14
CMSA Today - Issue 4, 2017 - 15
CMSA Today - Issue 4, 2017 - Community Health Workers: A Key Role on the Collaborative Care Team
CMSA Today - Issue 4, 2017 - 17
CMSA Today - Issue 4, 2017 - 18
CMSA Today - Issue 4, 2017 - 19
CMSA Today - Issue 4, 2017 - Ticket to Work: Strategies for Case Managers Who Face Work-Disrupting Disabilities
CMSA Today - Issue 4, 2017 - 21
CMSA Today - Issue 4, 2017 - 22
CMSA Today - Issue 4, 2017 - 23
CMSA Today - Issue 4, 2017 - 24
CMSA Today - Issue 4, 2017 - For Case Managers, Success Requires Mastering Today’s Challenges
CMSA Today - Issue 4, 2017 - 26
CMSA Today - Issue 4, 2017 - 27
CMSA Today - Issue 4, 2017 - Using a Patient Engagement Strategy to Help Care Managers Educate Patients at the Right Time—Before It’s Too Late
CMSA Today - Issue 4, 2017 - 29
CMSA Today - Issue 4, 2017 - Index of Advertisers
CMSA Today - Issue 4, 2017 - cover3
CMSA Today - Issue 4, 2017 - cover4
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