CM services may become more important than ever

Services will increase in importance

As the Commission on Certification of Case Managers (CCMC) celebrates its 10th anniversary, leaders in the case management field say the demand for case management will continue to grow as the health care system becomes more chaotic and complicated than ever.

The first Certified Case Manager (CCM) examination took place in May 1993, after more than two years of work by a group of professionals representing case management in a variety of disciplines, practice settings, and geographic locations.

"There is an increased need, not just because of the convolutions in the health care system but because there will be more people who are not well served. They will require someone who is not a hands-on provider to guide them through the process and act as their advocate," says Catherine Mullahy, RN, BS, CRRN, CCM, of Options Unlimited in Huntington, NY, and a member of the original task force that developed the credential.

Case managers are going to be dealing with an aging and more seriously ill population as the baby boomers grow older and people with catastrophic illnesses or injuries and people with complex care needs survive longer.

In addition, as the United States becomes more diverse, the number of people with cultural and language barriers can be expected to increase. These people will need an advocate to help them through the system. With increasing health care costs and more people who need complex care, case managers will be under pressure to move patients through the continuum quickly and ensure that they get the care they need.

"We have an opportunity to help resolve the problems that exist in health care delivery by putting a well-educated, experienced care manager in the center with the patient. We’ve talked for many years about moving patients into the community quicker and sicker. It has never been more so than today," says Patricia McCollom, RN, MS, CRRN, CMDM, CCM, CLCP, president of Management Consulting and Rehabilitation Service Inc. in Ankeny, IA.

McCollom chaired the original steering committee of the National Task Force on Case Management, which concluded that the certification of case managers was necessary. She is past chair of CCMC.

When leaders in the case management field were working on establishing the CCM credential, most case managers were either independent or in the insurance world, recalls Mindy Owen, RN, CRN, CCM, chair of ethics committee and a member of the CCMC executive board.

Fastest growing segment

Now, facility-based case managers are the fastest growing segment of the profession, she says.

Just 10 years ago, disease management and population-based management were practically unheard of, but they’re now a part of case management, Owen adds.

Owen believes that case management credentials eventually will have to include an additional credential representing the setting in which the case manager works, such as a hospital setting, workers’ compensation setting, or managed care setting, or a specialty credential such as an oncology case manager or a pediatric case manager.

The nursing shortage means hospital staff have less time for the patient education and patient monitoring that is necessary for good outcomes, making it more important than ever for a case manager to act as patient advocates.

Experienced case managers may be in short supply as those who began when case management was in its infancy retire, McCollom adds.

Educating the public about what case managers do is another challenge since a very small percentage of people has ever been involved with case management and most have no idea what "case management" means.

"Case management tends to be a buzzword, a title that everybody wants to have. The job descriptions inside case management have become so varied that they don’t always reflect case management or the function and skill sets needed for case management," Owen points out.

Having the CCM credential can help end some of the confusion, she adds.

"The certification ensures that the individual has a basic knowledge of case management and practices with the understanding of the standards of practice and the code of conduct," Owen explains.