234 Professional Case Management September/October 2010
Copyright © 2010 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
After a year of bitter political de-
bates and posturing on both sides,
healthcare reform in the United States
became a reality in late March.
Although legal challenges remain and
the anticipated overhaul will be rolled
out gradually, the changes wrought
by reform could very well be signifi-
cant for case managers. The reason is
care coordination, which has received
even greater attention lately as a
compelling answer to the pervasive
question: How can healthcare effi-
ciency and effectiveness be improved?
Care coordination is emphasized
across the spectrum of health and
human services as a proven means to
enhance the provision and delivery
of care and treatment resources. The
Agency for Healthcare Research and
Quality, in its June 2007 report,
“Closing the Quality Gap: A Critical
Analysis of Quality Improvement
Strategies: Volume 7—Care Coordin-
ation,” defined care coordination as:
…the deliberate organization of
patient care activities between two
or more participants (including the
patient) involved in a patient’s care
to facilitate the appropriate delivery
of healthcare services. Organizing
care involves the marshalling of
personnel and other resources
needed to carry out all required
patient care activities and is often
managed by the exchange of infor-
mation among participants respon-
sible for different aspects of care.
(McDonald et al., 2007, p. 18)
As stakeholders look to see who can
fulfill their demands for greater care
coordination, case managers will
stand out as an obvious choice.
Now, there is scientific research
that backs the premise that case
managers, and in particular certified
professionals, are particularly well
suited to the care coordination role.
The latest field research from the
Commission for Case Manager
Certification (CCMC) has identified
numerous essential activities and
knowledge statements related to the
competent practice of case manage-
ment today. As you will read in the
findings from the CCMC Role and
Function Study (see Case Management
Roles and Functions Across Various
Settings and Professional Disciplines,
2010, pp. 1–33), essential activities,
such as resource utilization and man-
agement, and knowledge statements,
such as healthcare management
and delivery, relate directly to care
coordination.
The need for greater care coordi-
nation today is widely acknowledged.
As Hospitals in Pursuit of Excellence
(HPOE) noted:
In today’s fragmented healthcare deliv-
ery system, hospitals are challenged to
coordinate patient care that involves
multiple providers and places.
Persistent fragmentation as patients
move from one setting to another con-
tributes to gaps in quality and effi-
ciency that adversely impacts their
care. (HPOE.org, n.d., Summary, p. 2)
Furthermore, the potential benefits
of care coordination are clearly recog-
nized. A November 2008 report from
the National Priorities Partnership,
convened by the National Quality
Forum, found that:
Care coordination is an important
aspect of healthcare that helps ensure
patients’ needs and preferences for
News and Views
A New Era for Case Management
Field Research Makes the Case for
Case Managers in Care
Coordination
Vivian Campagna, MSN, RN-BC, CCM
Address correspondence to Vivian Campagna,
MSN, RN-BC, CCM, Past Chair, Commission
for Case Manager Certification (ccmcvc@
gmail.com).
As stakeholders look to
see who can fulfill their
demands for greater care
coordination, case man-
agers will stand out as an
obvious choice.