Managing case management across the continuum: an organized response to managed care.

Case management is a core strategy for providing high-quality, cost-effective care in a managed care environment. Acute care case management programs most often originate as nursing-driven, hospital-based initiatives. Given the overwhelming trend toward vertical integration of health care organizations, hospital-based case management programs may be only an interim step toward a longer term strategy. Hospital and case management program leadership should consider how existing case management models can expand to meet patient and provider needs in an integrated health system or network environment. Key issues and strategies for designing a case management system based on continuum of care are described.