The lessons of case management

The health-care system works, for the most part, and patients who need help from case management are the exception rather than the rule. This has always been my belief, and this is what I have always advised. We even had statistics: 5%–10% of Medicare patients are high risk and need a case manager, and 6%–10% of patients account for 85%–90% of costs. Although these figures may be accurate, the small percentage indicating patients who need a case manager is no longer accurate. The health-care system is fraught with pitfalls, bureaucracy, disinterest, and delay. Even straightforward care is no longer straightforward in its delivery. Case managers may not be the answer to the woes of the health-care system, but we are surely the patient's last hope for navigating the maze.