US healthcare system

US healthcare system

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The American Case Management Association (ACMA), a non-profit association dedicated to the support and development of the profession of case management through educational forums, networking opportunities, legislative advocacy, and establishing the industry’s Standards of Practice, defines case management as care team a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality cost-effective outcomes.

There are several models of case management and the distinctions are based on internal and external influences that have bearing on the level of success and differences in outcomes. These, for instance, include local influences such as the response to cost by funders of care and consumer pressure. The generic model used in the United States is the chronic care model, which holds that health care does not only involve a change in the patient and that high-quality disease care counts the community, the health system, self-management support, delivery system design, decision support, and clinical information systems as important elements in the practice of case management. There are also group decision-making models such as the rational model, which focuses on economic perspectives and maximum utility; and, the garbage can model, an approach based on difficult problem identification and solutions under uncertain circumstances. Other models also prioritize ethics such as the distributive justice model developed by Beauchamp and Childress of the Kennedy Institute of Ethics, where ethics a component of the case manager’s responsibilities and is concerned with the distribution of finite resources for the benefit of an entire community.

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