Case management: a rich history of coordinating care to control costs.

The process of case management has been used to coordinate health and human services in the United States for more than a century. Throughout its history, case management has been practiced by a variety of disciplines, primarily nursing and the social service disciplines. Regardless of the degree of sophistication of the case management model or the discipline practicing case management, historically the goal has been the same--coordination of complex, fragmented services to meet the needs of the client while controlling the costs of services. As the health care industry continues to evolve during the managed care era, case management seems to be pervading all health care delivery systems as a means of dealing with the issues of access and quality while containing costs. The long history of case management provides a strong foundation for the refinement of case management systems to meet the needs of clients in the 1990s.