As the U.S. population ages and chronic diseases across all age groups continue to rise dramatically, so does the demand for case management professionals.
With registered nurses comprising approximately 85 percent of case management professionals in an industry enduring a nursing shortage, supply is unable to keep up with demand, said Jeff Frater, president of the Case Management Society of America, or CMSA.
The job front continues to be challenging in terms of uniform duties and advocacy, Frater said.
For instance, an emerging trend finds hospital-based care managers going beyond utilization management and review, as mandated for Medicare patients by the Centers for Medicare and Medicaid Services. Care managers are providing more proactive coordination of care through the development and implementation of care plans.
With an increasing focus on pay for performance, some hospitals look to case managers to gather, analyze and report on quality metrics data. While this trend is new, it is not uniform, according to Frater.
"Case management can be a hard sell for hospitals," Frater said, especially in this economically challenged environment. "It will take visionary hospital CEOs and administrators to advocate for proactive case management and to get staff cooperation."
Case managers may also look to hospital leaders to solve healthcare IT issues. While hospitals may be equipped with electronic patient registries and electronic medical records, billing systems and EMRs "are not perfectly built" for case managers to document care, noted Frater.
"There's a real need in this area and the demand is increasing," said Frater. He explained that the challenge lies not only in getting CEOs to invest in the right technology for care documentation, but in encouraging the vendor industry to develop applications suitable for case management.
Compounding the supply-and-demand constraints, case management professionals often end up in this line of work either by accident or default, which Frater described as "not ideal."
CMSA is hoping to change that dynamic by creating a career pathway for case management professionals, he said. The strategy, which is in its early stages, is to establish a public awareness campaign directed at young healthcare professionals that focuses on career opportunities and industry needs, and later to develop career tools.
CMSA's education committee will focus on developing the career path from an education standpoint. Only a small number of universities offer graduate-level case management programs, Frater said. Despite the obstacles and the imbalance in supply and demand, Frater pointed out that "there's a real opportunity" for healthcare professionals considering case management careers.