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The business case for hospital case management

Hospitalist Leadership Connection, March 14, 2007

A feature co-authored by a hospital case management consultant and a physician published in HealthLeaders magazine March 1 notes that recent incentives in hospitals have spotlighted the need for case managers.

The article cites hospital administrations' desire to improve relationships with the medical staff, the continuing refusal of insurers to pay for non-acute services, growing regulatory pressures, and the expansion of quality and safety measures among the reasons why executives now seek ways to manage and ensure the appropriate use of acute-care resources with an eye for improving quality and reducing costs.

The explosion of employed hospitalists is another reason many executives cite to explain the need to transform case management programs, the article states. As contracted employees, hospitalists often have economic incentives based on quality and financial outcomes. According to the authors, there is a trend toward creating partnerships that enable the hospitalist to concentrate on managing care while the case management partner concentrates on the business of managing care.

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