Hospital case management is the implementation of an in-hospital and post-discharge treatment plan that supports the individual needs of a patient. Case managers visit hospital patients to ensure that their specific medical needs are being met while they are in the hospital. Case managers also work with patients and social workers to develop post-care needs such as medical equipment, hospice care and home infusion supplies.
Because case managers are extremely familiar with different types of private insurance, Medicare and Medicaid regulations and guidelines, they generally work with attending physicians to ensure that in-hospital care and discharge practices are in line with the public or private insurance guidelines. They also use the insurance regulations to help their patients plan for the out-of-pocket costs associated with their post-acute care needs.
Once discharged from the hospital, patients who need long-term physical therapy, rehabilitation or specialized monitoring usually continue to work with their hospital case manager until the end of their treatment plan. Throughout this time, the case manager is normally on-call to answer questions regarding the patient's freedom to choose a different provider, the specific steps needed to transition from one level of care to another and to address any of the psychosocial needs that the patient might have throughout her extended treatment plan.