Case Management
Case management is a collaborative, client-centered process that assesses, plans, facilitates, and advocates for services to meet an individual's health and human service needs across multiple providers and systems[^c3]. The joint ACMA/The Commission 2022 definition frames it as "a dynamic process that assesses, plans, implements, coordinates, monitors, and evaluates to improve outcomes, experiences, and value," with explicit priorities around health equity, social determinants of health, and safe care transitions[^c1][^c7]. Approximately 10% of patients account for roughly 70% of all healthcare expenditures, and case management serves as a key strategy for improving outcomes while containing costs for this high-need population[^c4].
Case management has a heritage spanning more than a century, originating in nineteenth-century charity organization and settlement house movements and evolving through the deinstitutionalization era, the rise of managed care, and contemporary population health approaches. The Case Management Society of America (CMSA), formally incorporated in 1990, has driven the professionalization of the field through standards of practice, certification programs, and policy advocacy[^c5]. In October 2024, CMSA added Standard Q on Diversity, Equity, Inclusion, and Belonging (DEIB) and Health Equity, reflecting the profession's commitment to dismantling health disparities[^c6].
The practice is grounded in a structured process of client identification, comprehensive assessment, collaborative care planning, implementation and coordination of services, ongoing monitoring and reassessment, and planned closure. Core functions include assessing client needs and strengths, developing individualized service plans, linking clients to community resources, advocating for access to services, and evaluating outcomes. Professional associations including CMSA, the American Case Management Association (ACMA), the Commission for Case Manager Certification (CCMC), and the National Association of Social Workers (NASW) have established standards of practice, codes of ethics, and certification programs that define the knowledge, skills, and ethical obligations of case management professionals.
Case management is practiced across diverse settings including hospitals, community mental health centers, primary care clinics, child welfare agencies, aging and long-term care programs, criminal justice reentry services, and managed care organizations. Different models have been developed to meet the needs of specific populations, from brokerage models focused on service coordination to clinical case management models that integrate direct therapeutic intervention with environmental support. The field continues to evolve in response to changes in healthcare financing, technological innovation including artificial intelligence, demographic shifts, and growing attention to health equity and the social determinants of health.