Breaking through hospital walls: case managers build bridge to primary care.

Some case managers, dissatisfied with the fragmented nature of the health care system, are attempting to eliminate obstacles between inpatient and outpatient care by positioning themselves at the front line; the physician's office. Getting physicians to accept and value case managers, however, requires a financial incentive. Capitation, which forces physicians to pay closer attention to costs, outcomes, and patient wellness, can do the trick. In areas with less managed care penetration, you can encourage physician acceptance of case management by helping reduce the hassle of caring for chronically ill patients.