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CASE MANAGEMENT ... A GRAND OPPORTUNITY
Author: | Saturday July 04, 2009
CMSA Poster at recent national conference held in Phoenix.
Consumer Advocacy
A Motivational Force
By Ray Brasted
The future of the case manager in health care is secure and the profession is poised to be part of the trend toward consumer advocacy in their own treatment plans, according to an expert in the profession. Jeff Frater, President of the Case Management Society of America (CMSA) for the past year, told the Voice that the "need to get accurate information in order to make informed decisions" will draw on the expertise of case managers in the new era of healthcare.
The success rate of a particular surgeon in a specific procedure, the cost involved and the quality of service will be among factors consumers will take into account as they seek to direct their health care. "Consumers will be looking for help as they evaluate their findings," Frater maintained.
"I believe biggest role for CMSA is education and the development of the Case Management Adherence Guidelines (CMAG) was instrumental in giving case management a major voice in healthcare," Frater said.
(Developed in 2004, CMAG provides a comprehensive approach to addressing issues relating to adherence to therapies.)
Case managers are often facility-based with some working independently and others with case management companies. Frater anticipates the day when case managers will also be part of the medical team in physician practices, coordinating treatment plans and patient adherence to those plans.
"Health plans are not asleep at the wheel," Frater pointed out, in terms of providing value added services to their clients. Positioning case managers as patient advocates is a trend he believes will continue to evolve in the insurance industry. "We are moving in a bunch of directions," he added.
That does not necessarily include a rush to embrace new technology.
Frater said that there are still many excellent case managers who are not maximizing their skills because they have a fear of the computer age. "There are case managers who do embrace and effectively use technology," Frater said, but more professionals need to make the transition.
Case management will continue to evolve as a patient advocate profession, working as part of a team with insurers, physicians, providers and consumers to develop "value based" services, Frater predicted.
"I love being a case manager. I love the process and the opportunity to give back through CMSA. We have a vision that is breaking from the past and moving toward the future," Frater concluded.
Ed. Note: Jeff Frater, RN, BSN will conclude his term as CMSA President at the annual conference in June. He has experience in virtually all areas of health care administration including commercial health plans and small state Medicaid managed care organizations. He also has experience as an independent consultant working with long-term care insurance policies and case management software development.
Currently he is a Clinical Trainer for Milliman Care Guidelines.
His professional interests emphasize the patient as a "consumer of healthcare having full ownership of the process, medical record and ultimate outcome."
Frater has served as a Director of CMSA's Board from 2003-2006 prior to taking on the Presidency for 2008-2009. To learn more about CMSA visit www.cmsa.org.
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