EXECUTIVE SUMMARY

As a group, case managers in the U.S. are growing older, with nearly 44% over age 55. Coupled with the trend of increasing roles and needs for case management services, the industry is facing a shortage over the next decade.

  • Five years ago, a survey of case managers found that only 21% were over age 55.
  • Healthcare is evolving to a more patient-centric, coordinated care model.
  • Case management organizations are launching initiatives to market the profession to nurses, social workers, and other young healthcare professionals.

Case management — like nursing, primary care, and other healthcare professions — is facing a major brain drain in the next decade as the bulk of its membership heads toward retirement.

New data suggest the average age of case managers is increasing: Of the nearly 8,000 case managers who responded to a survey by the Commission for Case Manager Certification (CCMC) in Mount Laurel, NJ, 43.6% are over age 55, and only 1% are under age 30, says Patrice Sminkey, RN, chief executive officer of CCMC.

By contrast, five years ago, only 21% of case managers surveyed were over age 55, according to the CCMC Role and Function Study, which was released at the end of January 2015. 

“Most case managers come to the profession after a career in nursing or social work,” Sminkey says.

The aging trend is coupled with increasing demand for case management services — highlighting for CCMC, its nearly 50,000 members, and other organizations the need to market the profession to younger healthcare professionals, as well as to the public. The goal is to draw more experienced nurses, social workers, and other healthcare workers to case management as a career path.

“We know that the need for case managers is increasing dramatically as healthcare evolves to a more patient-centric, coordinated model of care,” Sminkey says. “So the commission is engaged in efforts to educate and inform professionals in a variety of settings about the opportunities for career advancement for qualified case managers.”

Finding qualified healthcare professionals who are interested in becoming case managers can be challenging, notes Veronica Chepak, RN, BSN, MPA, CPC-A, clinical coordinator of Bronx-based Montefiore Medical Center and the Montefiore Care Management Organization in Yonkers, NY.

“Case management is becoming such a huge part of healthcare,” Chepak says. “We need to reach out to younger people.”

There is a critical need for developing a case manager workforce with younger professionals in nursing, social work, and allied health fields, Sminkey says.

“Our research shows that case management as a profession is maturing,” she adds. “Not only are there many more opportunities for frontline case managers, but there is also an increase in the need for case management leaders and specialists in areas such as quality and education.”

Chepak has asked case managers and healthcare leaders about their perceptions of barriers to marketing the profession. She found that top barriers are a lack of identity and a lack of relationship-building.

“One of the healthcare leaders I spoke with was starting to reach out to nursing students to have them come in and see what case management was and how it was a potential career path,” Chepak says. “Care coordination is going to be such a big part of case management in the future.”

Other leaders said the profession needs to use the Web and social media, including Twitter, Facebook, and even Pinterest, to reach out to younger healthcare professionals, she says.

“We need a balance of traditional methods of marketing, as well as new methods for people who might want to be a part of the profession,” Chepak suggests.

The Hudson Valley Case Management Society in Tarrytown, NY, now has a committee devoted to membership, says Chepak, who is president of the chapter.

“We thought membership-building was important at the chapter level,” she adds. “Each state has their geographic issues and concerns they need to address.”

Chepak sent out an email blast and distributed pamphlets about an upcoming pre-test for certification for case management. The goal was to encourage social workers and nurses to consider a case management career track.

“Someone must have put it up on a bulletin board, and we were suddenly getting emails from people, saying they’d heard about the certification test and wanted to sign up for it,” Chepak recalls.

Unfortunately, a number of the callers were hospital workers in areas that wouldn’t be natural fits for case management, including custodial staff, dietary/nutrition area, and administrative assistants, she adds.

“We had to explain that you have to be an RN, social worker, or have a healthcare degree with two years of supervised experience,” she says. “A lot of people saw the job and thought, ‘Case management — I can do that and probably get better pay,’ not realizing there are certain experience and knowledge details you must have.”

This was Chepak’s lightbulb moment — a realization that case managers and their organizations need to do a better job of marketing the profession to the public and to other healthcare professionals.

“We need to explain to people what we are, what we do, and how to become a case manager,” Chepak says.

“Case managers need to go out there and advocate for their own profession,” she adds. “We do a great job of advocating for our patients and families, but we don’t do a good job of advocating for ourselves.”

This is starting to change, however.

In mid-2014, the Case Management Society of America (CMSA) launched a new website (www.cmsa.org/e4) that explains what case management services are and what kind of work case managers do. The second phase of the site was set to be complete by March 2015, says Danielle Marshall, chief strategy officer of Consulting Management Innovators (CMI) of Little Rock, AR, a management company for CMSA.

“There’s a real need to find ways to bring case managers into the field,” Marshall says. “That’s why CMSA has taken on this [e4 Web] project.”

With the website’s first phase, CMSA introduces case management with a competency map, a “What Is Case Management?” PDF, a flyer about case managers, a case management lexicon, and a case management program intensity grid and career framework overview.

“We’re trying to build more comprehensive resources that can be used by case managers,” Marshall says.

The second phase will attract new entrants to the field, and after that, CMSA will test the materials in focus groups and assess the impact, she says.

CCMC also promotes the case management profession whenever possible, Sminkey says.

“We take every opportunity to tell young nurses and social workers to consider case management, and we tell them the reasons why: personal autonomy, choice, career advancement, and opportunity,” she explains.

“We also do a survey of our own board-certified case managers on a regular basis,” she adds. “Last year, we discovered salaries for our board-certified managers exceeded average salaries for registered nurses and social workers — the two most common backgrounds for case managers.”

Another advantage to having a case management career is that it’s professionally satisfying, Sminkey says.

“As a case manager, you have a lot of choices,” she explains.

“You can easily move into a new setting with a new employer and tap into that same case management skill set, because it applies across all settings,” she adds. “If I were a younger case manager, I would find that very appealing.”