CMSA Today - Issue 2, 2018 - 16

I N T E G R AT E D C A S E M A N A G E M E N T

THE INTEGRATED CASE
MANAGEMENT PROGRAM:
Essential for Today's Case Manager

I

BY MARY MCLAUGHLIN-DAVIS, DNP, ACNS-BC, NEA-BC, CCM

thought that most health
professionals, and certainly
case managers, were beyond
segregating physical health, mental
and behavioral health. However, I
was mistaken. As recently as last week, I
overheard a hospital case manager tell her
manager she was not trained in mental
health, and therefore she did not want to
be assigned to a patient who had fallen at
a group home and suffered from paranoid
schizophrenia, diabetes and hemiparesis
from a previous stroke. It was then that I
realized that breaking the paradigm of a
divided mental health and physical health
case management approach had been a
process for me - not one in line with all
case management practices. I was fortunate
to be immersed in the Case Management
Society of America (CMSA) Integrated Case
Management (ICM) Training Program, which
hastened my own shift to the integrated case
management paradigm.
The emerging Population Health Model
focuses on managing the disease states present in a designated population. This model
requires efficiencies and patient-centric quality outcomes in order to be successful. The
Population Health Model, in any of its settings, will not demonstrate these outcomes
without a solid case management program.
Case managers in all settings, from workers'
compensation to acute care, must be trained
in ICM. They must be confident in their ability
to manage all aspects of a patient's presenting diagnosis and comorbid conditions,
16

CMSA TODAY

Issue 2 * 2018

and to manage them simultaneously. These
aspects include the medical and cognitive/
behavioral diagnosis with the social determinants of health.
The Population Health Model is similar
to the established Public Health Model. The
public health organization focuses on wellness and health maintenance, even though
many of the clients are chronically ill. The
public health professional counsels the family or inhabitants in the home and not just
the patient. She understands that everyone
is linked in important ways to one another
and that what happens to one person in the
family affects everyone in the family.
Public health, as a discipline, focuses on
disease tracking and prevention; however,
the focus of treatment is not necessarily the
disease. The focus here is on the social and
environmental elements affecting the disease, its origin, progression and cure for the

"To truly improve quality and
efficiency, those at the highest
risk for poor quality outcomes
and significant costs require a
special focus. CMSA's Integrated
Case Management approach can
be that specific focus."

individuals of the population served. Public
health professionals have long understood
the serious impact social determinants have
on the health of an individual as well as a
community or population.
The Medical Model, prevalent in acute and
ambulatory care, focuses on the disease, and
typically the disease is treated by a specialist
for that disease. The treatment can occur
simultaneously with other professionals
treating other diseases for the same person, or the diseases are treated in sequence.
However, the treatment is often provided
in silos and with a minimal acknowledgement of the role that the social determinants,
cognitive and behavioral health, and health
literacy play in disease management.
The Medical Model cannot be sustained
as healthcare costs in the United States
continue to escalate, and as the underlying
causes of diseases such as obesity, diabetes, heart disease and stroke and chronic
obstructive lung disease are not thoroughly
addressed. The Integrated and Population
Health Care Models are essential because
they link the social and medical problems,
which allow for comprehensive patientcentric care plans and realistic outcomes
(Valentijn, Schepman, Opheij, Bruijnzeels,
2013). Hence, the need for case managers
working collaboratively with the interdisciplinary team within an Integrated Population
Health Model.
Seventy percent of adults in the United
States experience a traumatic event at some
time in their lives. That is approximately



Table of Contents for the Digital Edition of CMSA Today - Issue 2, 2018

PRESIDENT’S LETTER
ASSOCIATION NEWS
CMSA CORPORATE PARTNERS
Opioid Use Disorder Case Management Guide
The Integrated Case Management Program: Essential for Today’s Case Manager
Patient and Family Advisory Council: Improving the Delivery of Care
Challenges and Opportunities for Acute Care Case Managers
Social Determinants of Health: Digging Deeper for Barriers in Successful Transitions and Self-Care
PAST PRESIDENTS CORNER
INDEX OF ADVERTISERS
CMSA Today - Issue 2, 2018 - Intro
CMSA Today - Issue 2, 2018 - cover1
CMSA Today - Issue 2, 2018 - cover2
CMSA Today - Issue 2, 2018 - 3
CMSA Today - Issue 2, 2018 - 4
CMSA Today - Issue 2, 2018 - 5
CMSA Today - Issue 2, 2018 - PRESIDENT’S LETTER
CMSA Today - Issue 2, 2018 - ASSOCIATION NEWS
CMSA Today - Issue 2, 2018 - 8
CMSA Today - Issue 2, 2018 - 9
CMSA Today - Issue 2, 2018 - 10
CMSA Today - Issue 2, 2018 - CMSA CORPORATE PARTNERS
CMSA Today - Issue 2, 2018 - Opioid Use Disorder Case Management Guide
CMSA Today - Issue 2, 2018 - 13
CMSA Today - Issue 2, 2018 - 14
CMSA Today - Issue 2, 2018 - 15
CMSA Today - Issue 2, 2018 - The Integrated Case Management Program: Essential for Today’s Case Manager
CMSA Today - Issue 2, 2018 - 17
CMSA Today - Issue 2, 2018 - 18
CMSA Today - Issue 2, 2018 - 19
CMSA Today - Issue 2, 2018 - Patient and Family Advisory Council: Improving the Delivery of Care
CMSA Today - Issue 2, 2018 - 21
CMSA Today - Issue 2, 2018 - Challenges and Opportunities for Acute Care Case Managers
CMSA Today - Issue 2, 2018 - 23
CMSA Today - Issue 2, 2018 - 24
CMSA Today - Issue 2, 2018 - Social Determinants of Health: Digging Deeper for Barriers in Successful Transitions and Self-Care
CMSA Today - Issue 2, 2018 - 26
CMSA Today - Issue 2, 2018 - 27
CMSA Today - Issue 2, 2018 - PAST PRESIDENTS CORNER
CMSA Today - Issue 2, 2018 - 29
CMSA Today - Issue 2, 2018 - INDEX OF ADVERTISERS
CMSA Today - Issue 2, 2018 - cover3
CMSA Today - Issue 2, 2018 - cover4
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