Case management in the social health maintenance organization demonstrations

Health Care Financ Rev. 1988 Dec;Spec No(Suppl):83-8.

Abstract

In this article, case management departments and roles during the early years of the social health maintenance organization (S/HMO) demonstrations are compared. These organizations provide acute and chronic care services under a prepaid plan for the elderly. Eligibility criteria for case management and chronic care services at each site are compared, followed by a description of the resultant case mix of members receiving chronic care benefits. Case managers principal activities are described, and a preliminary assessment is made about the strength of the linkages that have been developed between the case management component of these plans and the larger health care system.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Comprehensive Health Care / economics*
  • Health Maintenance Organizations / organization & administration*
  • Humans
  • Long-Term Care / economics*
  • Medicare / organization & administration*
  • Patient Care Planning / methods*
  • Pilot Projects
  • United States