As Simple as “I do, we do, you do”?Everyone who works in healthcare, whether it’s the janitor or the physician, the nurse or the social worker, the dietary aid or the occupational therapist, is there to help people. Yet everyone who works in healthcare is aware that there are major problems in the system. People who need care are not getting it, even with the Affordable Care Act.
Health plans have stepped up to the plate to participate more actively in assuring that people who need care get it. People like case managers, care coordinators, community health workers, patient navigators, and more, have been added to teams within insurance companies, community health agencies, HMO’s, and others who provide care coverage, to be the key ingredient in making sure people get the care they need.
Case Managers Addressing Non-Health Issues
Traditionally, case managers working in health plans were nurses or social workers who worked with patients over the phone to encourage them eat better, take their medications, and show up for their appointments. But demonstration projects to improve care, decrease costs, and make long-lasting impacts on people’s health, such as the Camden Coalition in New Jersey, have shown that unless patients’ other needs, such as housing, access to food, and help with mental illness or addictions are addressed, health progress is the last thing on their mind.
Learn more about the Care Excellence Foundational curriculum that teaches essential skills to those new to case management, care management, and those who would benefit from a review of fundamental knowledge and skills.
Listen to what Dr. Kelly Pfeifer of the California Health Care Foundation has to say on why health plans need to do things differently…
Consider the innovative approach of healthcare hotspotting, described by the Camden Coalition on their web site:
“Healthcare Hotspotting uses data to discover the outliers, understand the problem, dedicate resources, and design effective interventions. It is a movement for a new system of multi-disciplinary, coordinated care that treats the whole patient and attends to the non-medical needs that affect health: housing, mental health, substance abuse, emotional support.”
When the Camden model created a novel teaching approach called “I do, we do, you do.” A care manager or provider, when working with the patient to do something new, will do it for the person the first time. The second time, “we” will do it together. The third time, the case manager or provider acts as the coach in the background to the patient succeed.
Case Managers – Worthy of Trust?
What they are finding is that when you do this “I do, we do, you do” methodology is that people are much more likely to learn skills then be able to take care of the things they need, even when the case management stops. And as Dr. Pfeifer says, this is new kind of case management is the type of long-term approach that will “Make a difference in that person’s life. You have to convince them that you are worthy of their trust and that you have something to offer.”
Learn more about the Care Excellence Leadership series for supervisors, managers, and others in leadership roles.