Studies Demonstrate Powerful Impact of Effective Case ManagementIn healthcare, fiscal responsibility and patient outcomes are essential to the bottom line, and both are significantly impacted by the efforts, expertise, and effectiveness of case managers.
Case management grew from a program in the 1970s designed to integrate social welfare services, and has since evolved into an integral part of providing quality healthcare. It has continued to evolve in the shift toward value-based care initiatives that tie payment to patient outcomes.
A recent study by Harvard Medical School researchers compared eight years of data from patients enrolled in Blue Cross Blue Shield’s Alternative Quality Contract (AQC) to a control group in other states. The AQC is a population-based payment model that includes rewards and penalties for healthcare provider performance.
The study found there was slower growth in spending and savings that, over time, exceeded the incentives. In the early years of the study, the savings were driven by lower prices, but as the program gained momentum, the savings resulted from a lower utilization of services, including labs, emergency room visits, and some imaging.