Over the years, the care management model has changed dramatically. It was not too long ago that utilization review programs were in vogue and case management was just beginning to gain traction through programs funded by private and public payers.
Today, case managers are focused on making sure patients are getting the right care at the right time through enhanced care management models. It’s no longer about denying care, but making sure each patient is receiving the appropriate services to promote the most positive clinical and financial outcomes possible in any given circumstance.
This approach has led to a much more dynamic, customized approach to care management. MMARS, among other organizations, is on the front wave of this trend. We work with different program sponsors to design, implement and maintain high touch, dynamic interventions to help targeted populations address their chronic and acute care conditions.
Our ability to create these customized approaches is due to advancements in health information technology, evidence-based clinical pathways, more flexible staffing models, and enhanced communication platforms – among other resources.
With Chronic Disease Management and Prevention/Wellness being covered as one of the Essential Health Benefits under the Affordable Care Act, it’s important all of us work with policymakers, providers, payers and others to ensure that the latest in care management strategies are being deployed in the health care market place. If you want to learn more about these opportunities, please give us a call.
Carolyn Miller, RN
MMARS, Founder & President