Academic journal article Care Management Journals

Editorial

Academic journal article Care Management Journals

Editorial

Article excerpt

It is a known fact that for those individuals and organizations that have been providing case management services for an extended time, issues of policy deliberations and outcomes affect both the individual, the organization and the client. The case manager's work, the client's services and the organization's function are all involved in the implementation of the particular policy. There is a very thin line between what the client wants and what is paid for by the funder especially in publicly funded programs. Ethical dilemmas do arise and the organization needs to have a process for discussing these problem situations.

As the private insurance sector became involved in providing reimbursement and assuming a case management function for public programs, similar issues arose. However, the insurer was not familiar with the case manager's role and had to look for ways to deliver the services needed for reimbursement of the Medicare and Medicaid programs. …

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