The Evolution of Case Management Training: "What today's professionals need to know"
This program is intended to familiarize case managers and other healthcare professionals interested in the field of case management with the revised knowledge framework adopted by the Commission for Case Manager Certification (CCMC) in late 2015. This new knowledge framework went into effect for the CCM Certification Exam in August 2016. More generally, the new knowledge framework indicates the areas of focus and most current knowledge needed for case managers in their work with clients, other healthcare professionals and healthcare payors.
This eight module course introduces students to the new framework, including its similarities and key differences with the prior knowledge framework. Study of each new knowledge domain includes explanations of how concepts relate to the former framework and what modifications and new concepts have been introduced. Changes in the emphasis the CCMC places on various knowledge areas and functions are highlighted to allow case managers to understand the evolution of the profession.
The program has eight key learning objectives as listed below:
Objective 1: Introduction to Case Management
Develop a general understanding of the new knowledge framework, of certification and recertification requirements, of the case management profession and its philosophy and of the phases of the case management process.
Objective 2: Quality & Outcomes Evaluation and Measurement
Develop an understanding of “quality” in the healthcare context, including accreditation and quality indicators, of outcomes measurement, management and reporting and of the role of case managers in quality improvement.
Objective 3: Care Delivery
Develop an understanding of the evolving roles and functions of case managers and other providers and of the various care and case management models and healthcare delivery systems across the continuum of care.
Objective 4: Reimbursement Models
Develop an understanding of various types of insurance and reimbursement and payment methods, including public, private and an emphasis on military benefit programs, as well as an understanding of managed care, cost containment and utilization review/management concepts.
Objective 5: Psychosocial Concepts and Support Systems
Develop an understanding of the range of topics related to mental and behavioral health as they relate to a client’s care, including an emphasis on cultural competency, on client education and empowerment and on challenging situations such as abuse/neglect, chronic illness and disability and end-of-life.
Objective 6: Rehabilitation Concepts and Strategies
Develop an understanding of care processes, delivery systems and reimbursement models in the rehabilitation context, including assessments, outcomes and devices and technologies particular to rehabilitation services.
Objective 7: Regulatory and Legal
Develop an understanding of the key legal and regulatory requirements applicable to the practice of case management, including federal laws relating to patient-self determination, privacy, confidentiality, healthcare coverage, workplace safety and disability as well as general knowledge of the case manager’s role in risk management.
Objective 8: Ethics and Codes of Conduct
Develop an understanding of the ethics and codes of conducts applicable to the case management profession, including both the fundamental ethical principles generally applicable in the healthcare setting and the specific ethical obligations of case managers.
What is Case Management?
Case Management is a collaborative process that assesses, plans, implements, coordinates, monitors and evaluates the options and services required to meet the client’s health and human services needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes.” (CCMC, 2010, p.3)
or cost-effective care and improved outcomes for health care consumers.
What's the benefit of becoming Certified?
- It represents a level of expertise that will only become more valuable in the coming years as Federal and state-sponsored health programs seek to standardize
- From an insurance perspective, certification is becoming a standard practice. “You don’t have to be certified when we hire you, but it’s preferred, and you will have to get certification within three years.”
- Companies like Blue Cross Blue Shield of Kansas City reimburses case managers for the cost of continuing education to train for certification exams, and for the cost of the exam itself.
- In total, more than half of case managers say their employers either require certification or financially reward certification—or both
- Board-certified case managers number more than 37,000 today
- The percentage of employers who require board-certification is, growing, 40.2% in 2014 vs. 25.9% in 2004.
- More employers offer additional compensation for board-certification, 30% in 2014 vs. 20% in 2004.
- About 60% say that care management and care coordination are included in their job titles.
- Tens of thousands of professional case managers are employed in a range of health care settings and in independent practice
- According to the Bureau of Labor Statistics, case management is one of the fastest growing occupations. It is among the job categories projected to grow much faster than the average for all occupations.
(Facts provided by the Commission for Case Manager Certification)