CMSA Today - Issue 5, 2012 - (Page 7)
he common deﬁnition of an entrepreneur is a person who organizes and manages any enterprise, especially a business, while balancing initiative and risk. Originally coined by a French economist and later deﬁned by the Irish-French economist, Richard Cantillion, the term ‘entrepreneur’ has come to mean someone who is BY NANCY SKINNER, willing to begin a new enterprise and RN-BC, CCM be accountable for the outcome or outcomes achieved. One category of entrepreneurship is the social entrepreneur, who is motivated by a strong desire to advocate for improvement in social conditions including health care availability and delivery. Social entrepreneurs do not accept a lack of appropriate change simply because it has always been done that way. Nor are these innovators tied to a speciﬁc decision tree that might inhibit beneﬁcial change solely because prompting the desired outcome may be, both diﬃcult to initiate and, challenging to sustain. It is my opinion that the majority of case managers are truly social entrepreneurs, not only because they are engaged in the business of case management and care coordination, but also due to their ability to develop creative solutions for removing the barriers that prevent the delivery of appropriate health care services to the patients we serve. This entrepreneurial spirit drives case managers to incorporate the concepts of engagement, empowerment and education into each patient health care experience in order to support the primary goal of advancing the individual health outcomes that the patient strives to achieve. As case managers, we are change agents, facilitating change not for the sake of change, but change because that change brings value to the society we serve and beneﬁts the communities of patients we engage. As America looks to a health care system that is based in quality, the availability of case management interventions across each patient touch point, during each encounter with a health care professional and throughout each transition of care has never been more vital, more important or more needed than it is right now. In March 2011, the Department of Health and Human Services presented a National Quality Strategy that promotes: • Better Care – Improving the overall quality of care, by making health care more patient-centered, reliable, accessible, and safe.
Continually Advancing the Practice of Case Management
• Healthy People and Healthy Communities – Improving the
health of the population of the United States by supporting proven interventions to address behavioral, social, and environmental determinants of health in addition to delivering higher-quality care. • Aﬀordable Care – Reducing the cost of quality health care for individuals, families, employers, and government. (Report to Congress, 2011) It is my belief that this initiative will not be impacted by either political inﬂuence or legislative mandates. Basing care in quality is absolutely the right thing to do and an appropriate measure to address the fundamental needs of the American health care consumer. But the question remains, who will be the linchpin and the entrepreneurial force that balances quality and cost? And who possesses the entrepreneurial spirit and the key traits of ambition with both the emotional desire and the business focus to aﬀect that change? I strongly believe the answer is the case management professional. As a case manager, I follow and promote the Standards of Practice for Case Management as presented by your organization, the Case Management Society of America. This document presents a range of core functions, roles, responsibilities, and relationships that are integral to the practice of case management. And, although it is not a recipe for the provision of case management services, these Standards do comprehensively describe the social entrepreneurial role that is vital to the success of a case management plan. Case management must never become a “task focused” or “check oﬀ the tasks completed” profession. Although “tasks” may be a component of our roles, completion of those tasks can never be our sole function, our driving force or the only gauge of our success. Our Standards deﬁne our profession as follows: “Case management is a collaborative process of assessment, planning, facilitation and advocacy for options and services to meet an individual’s health needs through communication and available resources to promote quality cost-eﬀective outcomes.” The social entrepreneur in each of us demonstrates daily that this deﬁnition is accurate. Cost and quality stand, not in opposition, but as synergistic forces that advance the best care and the right interventions at the best available cost for our patients. It is that balance of ﬁscal responsibility and patient advocacy that created and sustained our ability to make a diﬀerence for our patients for more than two decades. Continued on page 19
Issue 5 • 2012 • DIGITAL CMSA TODAY 7
Table of Contents for the Digital Edition of CMSA Today - Issue 5, 2012
So, You Want to Be Your Own Boss?
Case Management Innovation and Entrepreneurship
Entrepreneurship: The Less-traveled Road in Case Management
Payment Information for the Medicare and Medicaid E HR Incentive Programs
CMSA Corporate Partners
Index to Advertisers
CMSA Today - Issue 5, 2012