What is the function of catastrophic case management (CM)?

The function of catastrophic case management is specifically designed to manage diseases in patients who incur very high costs of care. This type of management focuses on coordinating the complex needs of individuals with serious, chronic, or catastrophic health conditions, which typically result in substantial financial burdens due to extensive treatment and healthcare services required.

Catastrophic case managers review the patient's situation comprehensively, developing tailored care plans that may include coordinating various healthcare providers, ensuring patients receive the appropriate level of care, and facilitating access to necessary services. This is crucial as high-cost patients often require multifaceted treatment approaches, involving different specialties, medicines, and possibly long-term rehabilitation or support services. By effectively managing these cases, catastrophic case management helps to optimize health outcomes and control costs.

This type of management is distinct from preventive care, which aims to avoid illnesses before they occur, routine health services that focus on standard care and maintenance, and increasing administrative efficiency, which pertains more to the operational aspects of healthcare delivery rather than direct patient care.