Case management in the social health maintenance organization demonstrations.
In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system.
D000368:Aged; D003191:Comprehensive Health Care / Q000191:economics*; D006279:Health Maintenance Organizations / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care / Q000191:economics*; D006278:Medicare / Q000458:organization & administration*; D010347:Patient Care Planning / Q000379:methods*; D010865:Pilot Projects; D014481:United States