What Is Case Management and How Does It Affect Migrants
Case management is an integral component of the health care system, designed to deliver services to the enrolled patients in a holistic, cost-effective manner while preserving the quality of care. The matter, however, becomes a bit trickier for migrants who run into various challenges when seeking physical or mental care like access to health insurance, facing cultural and linguistic barriers, or legal gray areas to name a few. This article explores what the case management process encompasses, and how it may affect migrants in need.
What Is Case Management?
As defined by CMSA (Case Management Society of America),
“Case management is a collaborative process of assessment, planning, facilitation, care coordination, evaluation, and advocacy for options and services to meet an individual’s and family’s comprehensive health needs through communication and available resources to promote quality, cost-effective outcomes.
A case manager follows a process that ensures the most positive outcome possible, based on needs, objectives, and cost. In other words, the goal is to determine the optimum level(s) of service(s) that a patient can receive. “
So what is case management procedure?
At the enrollment stage, case managers evaluate eligibility. This ranges from checking available benefits to negotiating rates when healthcare insurance providers don’t cover services. This step may also involve outreach, as many people may not be aware they could receive assistance, in terms of both planning and therapeutic services.
Assessing one’s needs in the case management process is arguably one of the most important steps. To what extent is the patient ready/willing/able to participate? Have we explored all available options? Can we meet new needs in case of changes? Think of it as a holistic approach to understanding strengths, and most importantly barriers, at the physical, social, and emotional level.
Based on specific goals established with the patient, planning consists of defining a timeline and identifying activities and providers of appropriate services. Coordination is key to ensure the success of the program. Education and patient cooperation are also crucial elements to achieve the goals.
Case management is a documented process with milestones to evaluate progress, identify challenges while determining strategies to overcome them, as well as to leverage strengths to optimize the program effectiveness. All actors are encouraged to communicate and share information: patient, case manager, and service providers.
What is Case Management’s Affect Migrants?
Do migrants receive the same level of quality of care when they are chronically ill, need rehabilitation services, or should receive physical therapy after an injury? Immigrants seem reluctant to claim their rights to health care, or are overwhelmed by the complexity of the system. The challenge is even more acute for undocumented aliens who have no access to health insurance. Where do they go for health care? Their options narrow down to hospital emergency rooms, community clinics, or free medical and dental school clinics. When they exhaust these resources they have the option of medical repatriation through Allista.
Numerous articles and studies suggest that case management is not a readily accessible service to migrants. Beyond legal barriers or documentation requirements, they may face financial constraints, lack of transportation, or discrimination. Communication is a challenging factor, as well as cultural differences that case managers have difficulties understanding due to lack of training. In many instances, migrants will choose to not seek medical assistance, concerned they will be stigmatized, or face medical deportation.
What Options Exist for Migrants in Need of Health Care?
So what is case management’s barrier to being successful? Until the system makes room for legal changes, outreach efforts, education efforts, and training programs for care providers, migrants have to rely on their social/familial network or let their health deteriorate.
One other option that presents several advantages is for case management agencies and hospitals to partner with chronic care solutions providers and arrange for safe and ethical medical repatriation. Allista was created on the belief that working with case managers can bring positive outlooks for migrants and their families. Migrants can then receive the full scope of professional medical services they need, at a lesser financial burden for society, in a more welcoming and supporting environment.
The need for case managers and knowledge about what case management continues to grow in the United States. Added to the lack of more modern resources that could help them manage the workload, delocalizing post-acute health services is the most effective alternative.
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