Case management: a formula for resource conservation.

Abstract

Case management as a concept of efficiency and effectiveness has demonstrated its applicability in acute care. This article addresses one model of case management that integrates the traditional structure of independently functioning, nonrevenue-producing activities of quality, risk, and utilization management under the comprehensive umbrella of quality resource management. The model transformed existing full-time equivalent services at an acute care hospital in Florida into value-added services on behalf of patients, physicians, the hospital, and payers and presented a practical approach to organizing a case management program. Issues in the transformation process also are addressed.