1. Sminkey, Patrice V. RN

Article Content

Every 5 years, the Commission for Case Manager Certification (CCMC) undertakes major research into the practice of case management. This scientifically rigorous field survey is the most significant research conducted by the Commission (in partnership with highly respected researchers), and arguably is one of the most important and impactful in all of case management.


The most recent role and function study, conducted in 2014 with results analyzed and published in 2015, continues the Commission's legacy of field research that started in 1994, with subsequent studies in 1999, 2004, and 2009. The 5-year research cycle allows the Commission to detect and confirm changes in the field as they emerge, evolve, and then become part of routine practice.


The 2014 role and function study, the process and results of which are discussed in a two-part article series starting in this issue (see "What Case Managers Should Know About Their Roles and Functions," Part 1), served two very important purposes: The first was to identify the knowledge areas (what case managers must know) and the essential activities (what case managers do) to competently practice case management. The second was to apply these research findings to ensure that the Certified Case Manager(R) (CCM(R)) credential and the CCM(R) certification examination content remain relevant to case management practice.


The first purpose of identifying knowledge areas and essential activities was carried out through an extensive research process, starting with a panel of experts from diverse backgrounds who provided their expertise and insights into today's practice of case management. Next, an online survey instrument was sent out to more than 50,000 case management professionals, both board certified and noncertified, to collect as much input from the field as possible. Nearly 8,000 individual responses were collected and analyzed.


Based on this wealth of information, a current snapshot of case management practice was captured. Confirming what we have seen in today's era of health care reform, the study showed a stronger emphasis being placed on care coordination, care management, and care transitions to deliver more efficient and cost-effective services (CCMC, 2015).


The second purpose of ensuring the relevancy of the CCM(R) certification examination reminds us that certification exists to protect consumers. Therefore, the certification examination process and the content of the examination itself must be based on current practice. Because of the rigor of the research process into current case management practice, the CCM(R) credential is able to stand as a proxy of competence and professionalism. Through certification, case managers who come from a broad array of professional backgrounds, including nursing, social work, vocational rehabilitation, and others, continue to be positioned as leaders across health and human service settings.


The role and function study also revealed specific insights into case management practice, which are very important to professional case managers. These findings include:


* Nearly two-thirds of case managers spend at least half their daily time on direct case management services. More than one-third of case managers spend more than 80% of their time in direct case management.


* Case managers work in diverse work settings, including health insurance (28.8%), hospitals (22.8%), workers' compensation (11.6%), and independent case management (7.3%).


* A far greater percentage of employers-40.2%, a 14.7 percentage point gain from 2009-require certification. The percentage of employers offering a monetary reward (i.e., increased compensation) for certification is 29.9%, an increase from 20.2% in 2009.


* Care management and care coordination terms are included in the job titles of about 60% of the survey participants, underscoring the significance of these functions.


* Quality measurement and evaluation functions are receiving greater prominence in case management practice today, likely because of new care models based on value rather than volume (CCMC, 2015).


The role and function study also brought to light increased emphasis being placed on two specific aspects of practice-ethics and quality measurements. Although these areas have always been important, they are more prominent today, compared with the findings of previous role and function studies.


Board-certified case managers have always been expected to adhere to the highest of professional and ethical standards, as emphasized by the Code of Professional Conduct that was first adopted by the Commission in 1996 and revised and republished on the Commission's website in early 2015 (see Board-certified case managers recognize that their actions or inactions can aid or hinder clients in achieving their objectives; therefore, they must be responsible for their behavior (CCMC Code, 2015).


Quality measurement and evaluation of the systems of care delivery and their impact on patient care outcomes and experience of care are clearly a result of health care reform. Professional case managers are responsible today not only for care coordination and care management, but also for quality measurements and evaluations. In the context of transdisciplinary teams, the professional case manager tracks and evaluates outcomes that call to mind the "triple aims" of improvement in care, health, and costs.


These key findings, while hardly an exhaustive list, underscore the dynamics of the case management field of practice and greater expectations being placed on practitioners today. If the past is at all predictive of the future, we can be sure that case management will remain in the spotlight in the years ahead.


Through ongoing field research and the 5-year cycle of the role and function study, the Commission is dedicated to identifying the trends in health care and their impact on case management. Staying abreast of these changes ensures relevancy of the CCM(R), while also informing case management practitioners of current and emerging expectations for professional practice across the spectrum of health and human services.




Code of Professional Conduct for Case Managers with Standards, Rules, Procedures, and Penalties. (2015). Adopted by the Commission for Case Manager Certification.


Commission for Case Manager Certification. (2015). Changing roles and functions: what a professional case manager does is good for your health. Issue Brief. Retrieved from[Context Link]


Commission for Case Manager Certification. (2015). Role & Function Study Key Findings. Retrieved from[Context Link]