According to the Case Management Society of America, what is case management defined as?

Prepare for the HCQM Case Management Test. Study with interactive flashcards and multiple-choice questions, each with detailed hints and explanations. Ace your exam confidently!

Case management is defined as a process of care coordination and evaluation, according to the Case Management Society of America. This definition highlights the essential role of case management in organizing and overseeing patient care. The primary goal is to ensure that individuals receive the right care at the right time while effectively navigating the healthcare system. This involves assessing patients' needs, planning appropriate interventions, coordinating between different providers, and evaluating the outcomes to optimize the patient's health status.

Focusing on this approach allows case managers to facilitate communication among all parties involved in a patient's care, including healthcare providers, patients, and families, while also considering social determinants of health. This comprehensive process is critical for achieving improved patient outcomes, enhancing quality of care, and ensuring efficient use of healthcare resources.

The other options do not encompass the complete scope of what case management entails. While managing healthcare costs and improving billing procedures are relevant to healthcare administration, they do not reflect the core function of case management as described by the Case Management Society of America. Electronic health records management is also an important area in healthcare, but it serves different objectives than those of case management, which is fundamentally about coordinating care rather than managing data systems.

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