Care Management Plus

Introduction

Developed by Intermountain Health Care in Salt Lake City, Utah

Primary care physicians refer patients to a care manager (either a nurse of social worker) instead of a specialist

Care managers assess the patient's needs, help to create a care plan, & help implement that plan

• may involve
  • patient education
  • medication management
  • linking to community resources
  • tracking follow-up with other providers
  • patient follow-up
  • evaluating health outcomes

Notes

• associated with 20% reduction in mortality & 24% reduction in hospitalizations in older adults with diabetes mellitus
• 8-12% improvement in productivity for physicians who sent their patients to a care manager

More general terms

• Collaborative care model