How Case Managers Can Help Reduce Healthcare Costs

Case Managers are proving to be a vital piece of the integrated health management machinery as they can weave a complete picture by putting together a patient’s entire medical history along with any personal hurdles that the patient has that may hinder care. They are also excellent communicators who can coordinate between various providers to avoid failures that occur due to lack of communication. This helps in bringing down the healthcare expenses and boosting patient satisfaction.

Ineffectively managed chronic diseases are responsible for perpetuating agony and imposing life-altering restrictions on patients. Such ailments are usually prevalent amongst older individuals, and if mismanaged, they can prove to be a burden on the national economy. If you add to this narrative the fact that the population of older people in the United States is growing at an alarming rate, you get a terrifying picture of how severely the healthcare costs are about to inflate in the coming years. A report published by the Population Reference Bureau indicates that by the year 2060 the percentage of people over the age of 65 will increase to 24% of the total population. An increase of this proportion translates to a considerable hike in national healthcare costs. 75% of the total amount that is spent on healthcare in the United States today is already used for treating and caring for people suffering from multiple chronic ailments. Imagine how much this could increase if things continued to function the way they do now?

When patients suffer from several chronic illnesses at a time, they need to consult multiple specialists for diagnosis and intervention. They also undergo a range of tests and procedures. Sometimes they receive divergent viewpoints from different specialists they visit. In some grossly mishandled cases, two specialists may prescribe different medications that do not go well together merely because no one has a view of the larger picture and thus cannot intervene. Such incidents can be injurious to the patient’s well-being, lead to avoidable hospitalization costs, and cause redundancies in operation.

The answer to this complex issue is the installation of a Care Management model that focuses on information exchange. Case Managers are a part of this evolving care management ecosystem that aims to be highly integrated. In the simplest of terms, case managers are communicators. These people are certified professionals who are knowledgeable and adept at communicating with all the stakeholders in the entire care management cycle. For instance, they are the ones who are talking to the patient, all the providers that the patient is in consultation with, the patient’s family and all other entities involved in the patient’s care.

Read more: The Top 4 Mistakes That Plague Case Management Teams

For a practice that services patients who are suffering from chronic illnesses, it is vital to have Case Managers because:

1. Case Managers interact directly with the patients and educate them about coping with their condition.

They act as personal healthcare coaches who periodically get in touch with patients to discuss health goals, provide guidance on how to achieve these goals and gently steer them towards healthier habits like exercising, eating right and taking their medicines on time.

2. Case Managers prevent failures stemming from a shortage of interaction between the various specialists treating the patient.

Since case managers have a good idea of their patients’ overall medical history and health record, they can spot any miscommunication, conflicting medical advice by different specialists, or even an oversight that might happen if a provider does not have all the pieces of information related to the patient. A case manager can thus help in preventing a catastrophic outcome for both the patient and the provider.

3. Case Managers champion engagement.

They are good at listening to their patients and perceiving any possible obstruction to patient-care even after the patient is discharged. They are well-versed with nuances of the system and are aware of the community resources that can be tapped to benefit their patient. They are willing to go the extra mile to take care of the patient’s well-being.

If you are looking for great case managers who can help you service the chronically ill better, then Mirra Healthcare is there for you. Mirra is a third party-administrator that has a team of highly skilled case managers who can work with you to improve the overall efficacy of the care provided to your patients while giving each of your patients all the assistance they need to handle their condition better. For more information on how you can utilize the services in our Medicare in a Box solution, with our experts to learn more.