Case Management Society of America

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Case Managers Can Make a Difference

BY MARY MCLAUGHLIN-DAVIS, DNP, ACNS-BC, NEA-BC, CCM

Many times in my career, I have felt frustrated by bureaucratic barriers to delivering seamless care coordination. Case managers across the country and across the care continuum are familiar with the seemingly nonsensical decisions made about health care at all levels of administrations and government.

Have you considered that you, as a case manager, can make a difference in how these decisions are made? I was fortunate enough to be chosen to participate on the CMSA Public Policy Committee in the past, and I learned how influential case managers are with administrative decision makers. Over time I participated in discussions about the Nurse Compact Act, the TeleMed Act and The Medicare Transitional Care Act, among other pieces of pending legislation. I also made trips to Capitol Hill with CMSA and have visited the offices of our representatives.

Public policy is viewed as the standing decision of an organization. It reflects the beliefs of an administration and provides the direction and framework for the philosophy and mission of our government agencies (Milstead, 2013). CMSA revised the Standards of Practice in 2016, and the Case Management Model Act this year, to inform our government on the importance of case management to population health. The Case Management Model Act provides a framework for an effective case management program, optimizing value-based purchasing through title protection, measurable clinical outcomes and clinical integration across the continuum with care coordination delivered by a licensed case manager.

Case managers know that relationships are instrumental in achieving goals. Our interdisciplinary membership has forged relationships over the years with our legislators, and these relationships are essential to continue to improve the lives of our patients, clients and veterans and to insure professional licensed case managers are providing case management services.

It is through CMSA membership that we exercise one voice for case management, and we can use our knowledge, experience and influence to inform and persuade the administrations of our employers, as well as our government officials on all levels, of the value of professional licensed case managers.

Reference

Milstead, J. A. (2013). Advanced practice nurses and public policy, naturally. Health policy and politics: A nurse’s guide, 1-27.

Mary McLaughlin-Davis, DNP, ACNS-BC, NEA-BC, CCM

President, CMSA 2016-2018

Dr. McLaughlin-Davis is the president of CMSA. She has been a certified case manager since 1993; she is a clinical nurse specialist for adult health and the senior director for care management for Cleveland Clinic, Avon Hospital.

 

Photo credit: Rob Wilson/Shutterstock.com

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