Case managers are being used by medical facilities and insurance companies at an increasing rate. They are to assist the client in their healthcare without sacrificing needs but still remain within the guidelines of the insurance companies

Question

a. Do you see case managers as beneficial if they have 10 to 20 clients and they address each of their needs by the sickest, most complicated, most needy, then someone who is in need of short-term assistance?
b. Can the case managers be at a disadvantage when the insurance companies do not agree with the physician on the client's need for placement or care? Explain.
c. Do you foresee an increase in use of case managers with the changes in healthcare in your local area?

Answer 1

Students' answers should include the following:
a. Discussion on the rankings of clients the case managers have as a case load at one time could be done here. How do they choose which client to focus the majority of their time to meet insurance, facility, and client needs? Which client is selected to get the best care, and how are they chosen?
b. Discuss on what advantages and disadvantages the case managers have when they are trying to place a client. Who is involved besides the physician, client, and case manager? How is the client affected when the criteria doesn't meet what the insurance will cover?
c. This would be a discussion based on what is going on in the news and in the area around the students. What is going on with case managers that they are seeing in clinic at the local level?