CMSA and DMAA to promote fully-connected health care system to improve clinical and financial outcomes

The Case Management Society of America (CMSA) and DMAA: The Care Continuum Alliance (DMAA) are working together to strengthen and define the relationship between health care "case management" and "population health management" interventions. This dynamic collaboration between the two health care associations will promote a fully-connected health care system that will improve clinical and financial outcomes.

CMSA and DMAA support the belief that managing health requires the active, integrated involvement of all health care professionals coordinated with the patient along with their caregivers and families. The organizations intend to work together to identify, evaluate, and enhance key interventions to provide a roadmap for quality-based programs for the chronically ill and others. To lay the groundwork for the alliance, they plan to develop a consensus statement detailing the interactions between case and population health management strategies that will foster collaboration and transparency, and ultimately more effective programs.

"Case management interventions are used throughout the health care system today as a very effective solution towards the transition of care, coordination of resources, reducing costs and improving clinical outcomes," said CMSA Executive Director, Cheri Lattimer, RN, BSN. "Working with DMAA demonstrates the importance of case managers becoming a fundamental element of health care reform."

Tracey Moorhead, DMAA President and CEO, called the joint effort "a valuable strategy to address health needs at all points along the continuum of health and well being, through participation of, engagement with, and targeted interventions for the population." She explained that "through this partnership, we can work together to ensure a fully-connected health system, leveraging teams of care providers, focused on proactive, coordinated, quality health care."

The initial collaborative effort of CMSA and DMAA recently came to fruition in August with the adoption of "The Case Management Model Act of 2009," which set forth important standards for case management services with key provisions covering staff qualifications, case management functions, authorized scope of services, payment of services, training requirements, quality management programs, and antifraud and consumer protections. Provisions of the Model Act, which is available for download at http://www.cmsa.org/HealthReform, can be adopted either at the federal or state levels through either legislative or regulatory bodies.

The next major joint effort for the two organizations will be definition clarification related to CMSA's Standards of Practice, a dynamic and timely document which establishes formal written standards of practice from a variety of disciplines.

CMSA defines "case management" as a collaborative process of health care that strives to meet an individual's comprehensive health needs through the following steps:

• Assessing
• Planning
• Facilitating
• Coordinating

DMAA has identified three core components of "population health management":

• The central care delivery and leadership roles of the primary care physician;
• The critical importance of patient activation, involvement and personal responsibility; and
• The patient focus and capacity expansion of care coordination provided through wellness, disease and chronic care management programs.