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What is a “Care Manager”, and Does your Practice Need One?

Dovetail Care Manager Blog Post

The position of care manager is a growing trend in primary care practices. Care managers serve many purposes. Their job responsibilities vary from clinic to clinic. You may be wondering what exactly a care manager does within a practice and if you need one as well. So let’s take a closer look at this job role and the value they bring to any practice.

Care Manager – What and Why

More adults suffer from chronic ailments than ever before. These can range from mental illness to behavioral or physical issues like obesity, diabetes etc. Care management for chronic ailments is different from the treatment options for acute conditions. Such problems need a mix of short term and long term strategies. Patients may need services from different providers. Their medical records are often voluminous.

A care manager works with the practice to develop management plans for groups of patients and also tailors them for individual patients. Their duties generally include updating EHR records, coordinating care and treatment options, providing support for self management etc. Some care managers even work with insurance companies to determine coverage for their patients.

In practices without a care manager, these duties are often fulfilled by social workers, nurses and even pharmacists. That may not be optimal for ensuring positive patient outcomes. Properly trained care managers are able to dedicate more time to patient needs and offer much needed support to over worked health care providers. Practices that follow a care management model have a higher percentage of patients who reach their goals than those without.

Do You Need a Care Manager?

Whether or not your clinic could benefit from a care manager depends on various factors. The size of the practice, the type of patients you see and even the number of existing employees will play a role in answering this question. Smaller practices may not have the resources to train and support a care manager on the payroll. Specialists who mainly treat acute conditions will not have a need for care management at all. Sometimes a practice has enough employees who already follow a care management plan, which means another person is not strictly necessary.

Identify Your Needs

If you feel that your patients can benefit from a care manager, it’s time to consider what their role will be and what qualifications they should have. Many care managers work in practices with specific patient profiles. Suppose your practice primarily treats senior citizens. Then your care manager should have training in geriatric care, nursing and experience working with older patients (and their caregivers). Care managers will need different qualifications if your patients are children or toddlers, if your practice treats mental issues or specific chronic ailments like obesity and so on.

As we have seen before, care managers also work with the practice to implement care management plans, develop community resources, tip sheets, help patients in setting and achieving targets and so on. Care managers can be valuable allies when it comes to communicating with patients, especially if physicians don’t have the time for detailed assessments or prolonged interviews. They can get patients to open up about their problems and get them into the exam room.

Some aspects of care management like medication and treatment options will involve the physician. But there are several aspects where the patient and care manager can work together to manage chronic illnesses. These include out of clinic strategies, ongoing support and serving as a single point of contact for patients. If it sounds like you could use a care manager on the payroll, don’t hesitate! It can make a world of difference to your patients.