CMSA Today - Issue 6, 2017 - 28

CARE STUDY

FIRST CASE
MANAGEMENT
PROJECT
FOR PATIENTS WITH SEVERE MENTAL DISORDERS
IN GERMANY ESTABLISHED
BY JOHN ACHIM BEISSEL AND IRIS HAAG

B

IG direkt gesund, a 450,000-member
statutory health insurance
company in Dortmund, Germany,
has successfully established a
case management program for
members with severe mental disorders like
depression and schizophrenia.
In the early years, beginning in 2000,
Germany began implementing the now wellknown Disease Management Programs, which
are made for patients with chronic somatic
diseases such as diabetes and COPD. Case
managers, employed by the health insurance companies, worked with patients by
calling them or by writing letters to ensure,
for instance, that doctor appointments were
planned and attended. In the original programs, case managers did not leave the office
to get in touch with the patient.
To make this way of case management
and practice more like "the CMSA way," in
December 2014 BIG direkt gesund announced
European-wide bidding for case management
companies to make proposals for home-based
case management for patients with severe
mental diseases. These patients are often left
alone in the system, yet they have easy access
for many admissions to hospitals.
GPS, a German case management company, won the bidding. Iris Haag, taskmaster
for GPS, and John Achim met several times
to identify around 450 members in the state
of North Rhine-Westphalia (NRW) who were
eligible to join the program. Requirements for
eligibility included:
28

CMSA TODAY

Issue 6 * 2017

* Severe mental disorders;
* At least two hospital admissions per year;
* No drug or alcohol abuse.
Due to the limited resources of GPS, the
program was open for 60 patients. The
other eligible participants served as the
control group. Each of the 60 patients had
a case manager for the entire 12 months in
a home treatment setting. The case management goal was to improve adherence
of the patients, close the medical gaps,
build bridges to community service and
last but not least, to reduce the number of
hospital admissions.
After 12 months, the results were tremendous (GPS Group vs. Control Group):
* Hospital costs per patient decreased by
73 percent.
* Hospital costs per case decreased by sixty
percent.
* Hospital admissions per member of the
group decreased by 73 percent.
* Hospital admissions per patient decreased
by 34 percent.
Feedback from the 60 GPS patients was
positive, with one participant remarking, "It
was so good that a case manager helped me
at home to get back on track."
The case management project has been
nominated for the MSD Sharp & Dohme
Healthcare Award, to be announced
September 6, 2017, in Munich, Germany;
a total of 60 projects were submitted, 10
projects were nominated and the top three
projects will be awarded as winners. Due to

the program's success in the state of NRW,
BIG direkt gesund will provide this program during the year 2017 across the entire
country. There are also plans to provide this
kind of case management for patients with
intensive somatic disorders.
To offer a follow-up solution for the 60
patients who increased their adherence
during the program, John Achim is working with the startup company Blue Bird
Technology, located in Berlin, Germany, to
develop a medical mobile application offering
self-management via APP technic in combination with emergency case managers for
home treatment. ■
John Achim Beissel
is head of inpatient
management for
BIG direkt gesund in
Dortmund, Germany,
and an international
member of CMSA
since 2010. He can
be reached at Achim.Beissel@big-direkt.de.
Iris Haag is head of
HR, administration
and finance for GPS
GroschPatienten
Service in
Waiblingen,
Germany. She
can be reached at
iris.haag@grosch-ps.de.



Table of Contents for the Digital Edition of CMSA Today - Issue 6, 2017

President’s Letter
Association News
CMSA Corporate Partners
Highlights of the 27th Annual Conference & Expo
Words From a Past President of the Case Management Society of America
Optimizing Electronic Health Record Technology to Maximize the Value and Efficiency of Care Coordination
First Case Management Project for Patients With Severe Mental Disorders in Germany Established
Index of Advertisers
CMSA Today - Issue 6, 2017 - Intro
CMSA Today - Issue 6, 2017 - cover1
CMSA Today - Issue 6, 2017 - cover2
CMSA Today - Issue 6, 2017 - 3
CMSA Today - Issue 6, 2017 - 4
CMSA Today - Issue 6, 2017 - 5
CMSA Today - Issue 6, 2017 - President’s Letter
CMSA Today - Issue 6, 2017 - 7
CMSA Today - Issue 6, 2017 - Association News
CMSA Today - Issue 6, 2017 - 9
CMSA Today - Issue 6, 2017 - CMSA Corporate Partners
CMSA Today - Issue 6, 2017 - 11
CMSA Today - Issue 6, 2017 - Highlights of the 27th Annual Conference & Expo
CMSA Today - Issue 6, 2017 - 13
CMSA Today - Issue 6, 2017 - 14
CMSA Today - Issue 6, 2017 - 15
CMSA Today - Issue 6, 2017 - 16
CMSA Today - Issue 6, 2017 - 17
CMSA Today - Issue 6, 2017 - 18
CMSA Today - Issue 6, 2017 - Words From a Past President of the Case Management Society of America
CMSA Today - Issue 6, 2017 - Optimizing Electronic Health Record Technology to Maximize the Value and Efficiency of Care Coordination
CMSA Today - Issue 6, 2017 - 21
CMSA Today - Issue 6, 2017 - 22
CMSA Today - Issue 6, 2017 - 23
CMSA Today - Issue 6, 2017 - 24
CMSA Today - Issue 6, 2017 - 25
CMSA Today - Issue 6, 2017 - 26
CMSA Today - Issue 6, 2017 - 27
CMSA Today - Issue 6, 2017 - First Case Management Project for Patients With Severe Mental Disorders in Germany Established
CMSA Today - Issue 6, 2017 - 29
CMSA Today - Issue 6, 2017 - Index of Advertisers
CMSA Today - Issue 6, 2017 - cover3
CMSA Today - Issue 6, 2017 - cover4
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