Case management in a vertically integrated health care system.
A comprehensive case management system has been developed at Fallon Healthcare System, with overall aims of improving medical, social and financial outcomes for health plan members who need complex patient care management. A definition of case management is offered, goals of case management services are specified, criteria for appropriate referrals are outlined, and the process of implementing services is described. Formal evaluation of the program is being planned.
Blase
N J
NJ
Fallon Community Health Plan, Worcester, MA, USA.
Kaufman
J M
JM
D000367:Age Factors; D000368:Aged; D019090:Case Management; D019033:Delivery of Health Care, Integrated / Q000458:organization & administration* / Q000592:standards; D015577:Geriatric Assessment; D006279:Health Maintenance Organizations / Q000458:organization & administration* / Q000592:standards; D006801:Humans; D008404:Massachusetts; D009937:Organizational Objectives; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team; D012017:Referral and Consultation; D018570:Risk Assessment