It should be an exciting time for case managers. Healthcare reform is in it’s creation and The RAC (is it not the perfect nom de guerre?) is knocking on our doors. Yet I hear nothing from our ranks or leadership weighing in on the issues.President Obama recently made notice of an article in the New Yorker by Dr. Atul Gawande. This article was about a Texas city that had the highest cost per Medicare patient in the US. It’s conclusions said nothing that any nurse case manager could not have told him about over utilization. The reform issue of “how are we going to make universal healthcare affordable?” is all about case management principles. If the future of healthcare delivery is going to be based on the principles of the right care and the right time, it is going to take case managers to make it work. Focusing on the here and now, The RAC is the best thing ever to happen to hospital based case management. Hospitals will not be able to survive without strong UR/ case management programs.
Ray Gridey, RN BS, CPUR – Case Manager