CMSA Today - Issue 7, 2017 - 23

PROFESSIONAL CASE MANAGERS TRANSFORMING HEALTH CARE
BY PATRICIA NOONAN, RN MBA, AND CHRISS WHEELER, RN, MSN, CCM

re certain to miss the future.

I

- John F. Kennedy

N S F O R M I N G H E A LT H C A R E
Case Management Impact on the Health Care System
Standards of Practice
for Case Management
The Evolution of the Standards
The Definition of Case Management
Philosophy and Guiding Principles
Case Management Practice Settings
Components of the Process
Standards of Case Management
Acknowledgements and Glossary

Revised 2016

m
ervices.

SoP mock up cover 2016 FINAL.indd 1

6/2/16 9:05 PM

Case management guiding principles, interventions, and strategies are targeted at the
achievement of client stability, wellness and autonomy through advocacy, assessment, planning,
communication, education, resources management, care coordination, collaboration, and service
facilitation.
Case management interventions are used throughout the health care system as an effective
solution towards transitions of care, coordination of resources, reducing costs and
improving clinical outcomes.
CMSA Standards of Practice for Case Management, 2016

scipline that allows the
ractice of the discipline;

rtification, the individual
n services field that
served.

Save the Date CMSA "Day on the Hill" September 13-14, 2017

The Importance of Advancing the CM Model Act
CMSA Standards of Practice for Case Management, 2016
into Health Policy
* Professional Case Management roles and functions lead to quality and outcomes.

m

* Successful outcomes cannot be achieved without the specialized skills, knowledge and competencies
professional case managers apply throughout the case management process.
* Professional case manager competencies include critical thinking, analysis, motivational interviewing,
effective communication, positive relationship building, ability to plan, organize effectively,
negotiation, cost-conscious allocation of resources, knowledge of health insurance and funding
sources, client activation, empowerment, engagement, ability to effect change and perform
ongoing evaluation.
* The professional case manager is uniquely positioned as an expert in care coordination and
advocacy for health policy change to improve access to quality, safe, and cost-effective services.

n

* Case management guiding principles, interventions, and strategies target the achievement
of optimal wellness, function and autonomy for the client, and clients family or family
caregiver through advocacy, assessment, planning, communication, health education, resource
management, care coordination, collaboration, and service facilitation.
* Case management interventions focus on improving care coordination and reducing fragmentation
of the services the recipients of care 0often experience.

mpion?

* Case management interventions are intended to enhance client safety, well-being, and quality of life.
* Effective case management positively impacts the health care delivery system, especially in realizing the
goals of the Triple Aim which include improving health outcomes of individuals and populations, enhancing
the experience of health care, and reducing the cost of care.

Professional Case Managers
as Transformational Leaders
®

CASE MANAGEMENT SOCIETY OF AMERICA

PUBLIC POLICY

sion

*Model the way
*Inspire a shared vision
*Challenge the process
*Enable others to act
*Encourage the heart

Kouzes and Posner
Leadership Model, 2007

n June 2017, Patricia Noonan, RN,
MBA, CCM and Chriss Wheeler,
RN, MSN, CCM of the CMSA
Public Policy Committee, presented
"The Case Management Model
Act: Professional Case Managers
Transforming Health Care" at CMSA's
27th Annual Conference & Expo in
Austin, TX. The following describes
the objectives and goals of the poster
presentation.
Who are professional case managers;
what is the Case Management Model
Act; and why must this important message be delivered to our policymakers?
Professional case managers are qualified health care professionals who are
guided by the standards of practice for
case management to deliver quality, efficient health care services. Professional
case managers are recognized experts
and vital participants in the care coordination team who empower people to
understand and access quality, safe and
efficient health care services according
to the CMSA Standards of Practice for
Case Management.
With the recognition that professional
case managers offer an effective solution
to promote quality care and outcomes
with a wide range of populations across
all health care settings, CMSA launched
the Case Management Model Act in
2009, which set forth important standards for case management program
services. The Case Management Model
Act outlines key components of a comprehensive case management program
that should be implemented at both the
federal and state levels.
Professional case managers are
uniquely positioned with their knowledge
and skills as experts in care coordination
to improve our healthcare system. This
is an important message that must be
delivered to our policymakers. With the
rise in the chronic condition population
and the need to control health care costs,
the Case Management Model Act sets
forth important program standards that
should be implemented in our twentyfirst century value based programs to
improve our healthcare system. ■

5/18/17 4:51 PM

DIGITAL * Issue 7 * 2017

CMSA TODAY

23



Table of Contents for the Digital Edition of CMSA Today - Issue 7, 2017

President's Letter
Association News
CMSA Corporate Partners
Care Transitions: Remember the Basics
Leveraging Family Caregivers, Clinical Protocols and Technology to Improve Person-Centered Care
Development and Implementation of Relational Building in the Virtual Work Environment
Patient and Provider Satisfaction
The Case Management Model Act: Professional Case Managers Transforming Health Care
Index of Advertisers
CMSA Today - Issue 7, 2017 - Intro
CMSA Today - Issue 7, 2017 - cover1
CMSA Today - Issue 7, 2017 - cover2
CMSA Today - Issue 7, 2017 - 3
CMSA Today - Issue 7, 2017 - 4
CMSA Today - Issue 7, 2017 - 5
CMSA Today - Issue 7, 2017 - President's Letter
CMSA Today - Issue 7, 2017 - 7
CMSA Today - Issue 7, 2017 - Association News
CMSA Today - Issue 7, 2017 - 9
CMSA Today - Issue 7, 2017 - CMSA Corporate Partners
CMSA Today - Issue 7, 2017 - 11
CMSA Today - Issue 7, 2017 - Care Transitions: Remember the Basics
CMSA Today - Issue 7, 2017 - 13
CMSA Today - Issue 7, 2017 - 14
CMSA Today - Issue 7, 2017 - Leveraging Family Caregivers, Clinical Protocols and Technology to Improve Person-Centered Care
CMSA Today - Issue 7, 2017 - 16
CMSA Today - Issue 7, 2017 - 17
CMSA Today - Issue 7, 2017 - Development and Implementation of Relational Building in the Virtual Work Environment
CMSA Today - Issue 7, 2017 - 19
CMSA Today - Issue 7, 2017 - Patient and Provider Satisfaction
CMSA Today - Issue 7, 2017 - 21
CMSA Today - Issue 7, 2017 - The Case Management Model Act: Professional Case Managers Transforming Health Care
CMSA Today - Issue 7, 2017 - 23
CMSA Today - Issue 7, 2017 - 24
CMSA Today - Issue 7, 2017 - 25
CMSA Today - Issue 7, 2017 - 26
CMSA Today - Issue 7, 2017 - 27
CMSA Today - Issue 7, 2017 - 28
CMSA Today - Issue 7, 2017 - 29
CMSA Today - Issue 7, 2017 - Index of Advertisers
CMSA Today - Issue 7, 2017 - cover3
CMSA Today - Issue 7, 2017 - cover4
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