Medical Case Management: Coordinated Care for Optimal Patient Outcomes
Medical Case Management (MCM) involves coordinated healthcare services to ensure patients receive appropriate, efficient, and cost-effective care. Case managers—often nurses, social workers, or healthcare coordinators—assist patients in navigating medical, social, and financial needs.
Key functions include:
Patient assessment and care planning
Coordination with healthcare providers
Scheduling and monitoring treatments
Ensuring medication adherence
Facilitating rehabilitation and follow-up
Educating patients and families
Managing insurance and documentation
MCM is critical in chronic illnesses, trauma care, mental health, disability management, oncology, and workers’ compensation cases. It improves outcomes by reducing hospital readmissions, preventing treatment delays, and optimizing resource use.
With digital health advancements, AI-enabled case management and telehealth follow-ups are improving efficiency and patient support systems.