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case management, environmental scanning change



  1. Stanton, Marietta P. PhD, BC, RN, CNAA, CMAC, CCM
  2. Barnett Lammon, Carol Ann PhD, RN


Purpose/Objectives: A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management.


Primary Practice Setting(s): The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings.


Findings/Conclusions: The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice.


Implications for Case Management Practice:


* Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality.


* A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance.


* Case managers perceive that these trends have a predominantly positive impact on case management.