The American Health Care System In The American Healthcare System

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Introduction to Case Management The American healthcare system is a system with many different healthcare providers, insurance companies, specialists, hospitals, clinics, and many other agents that each pedal individual services. A patient may be required to have a referral from their primary healthcare provider to see a specialist for a physical ailment. They may require another referral to another specialist for mental health. As such, primary healthcare providers do not connect but simply refer and suggest other services. The system is fragmented (Alkema et. al, 2003). However, this fragmentation is not merely prevalent in the healthcare system but other large networks of services required for clients to live health productive lives as…show more content…
Individuals requiring a range of services that must be individually monitored, who may need support in seeking out services, coordinating their treatment, and then monitoring their treatments and progress, who may have chronic illnesses that must be treated over time and thus requires follow-ups, who may need and advocate or coordinator will all benefit from a case manager. Case management will greatly improve the lives of the most vulnerable groups in a population, “including those at highest risk of institutionalization, with the lowest levels of social support, or with multiple, chronic problems” (Scharlach et. al, 2001). Other criteria, as stated by the CMSA, include “low functional status or cognitive deficits, social issues such as history of abuse, repeated emergency department visits, poor nutritional status, financial issues, health literacy and illiteracy” and more (Standards of Practice for Case Management, 2010). As such, it seems that most people who feel as though they need help in managing their health as well as many who do not know they need help will all benefit from a case management
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