The Role of Case Management: Improving Outcomes and Addressing Health Disparities in Cancer Care

In order to meet the multifaceted needs of cancer patients, the role of case management in cancer care has recently grown.

By Marissa Fors, LCSW, OSW-C, C-ASWCM, CCM

Cancer patients face many obstacles to care, including financial, psychosocial, and practical barriers. Health disparities also prevent patients from receiving optimal treatment. In order to be an effective case manager, health care professionals must have a clear understanding of the definition of this role, the overall benefits of case management, and how to assess patients’ needs. The priority must be to put the patient first in order to improve outcomes. Addressing inequities in access to care is essential to adequately enhance a patient’s wellbeing.

Case Management Within Professional Practice

According to the Commission for Case Manager Certification, case management is a "collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet the client's health and human service needs. It is characterized by advocacy, communication, and resource management and promotes quality and cost-effective interventions and outcomes."1

Nurses, social workers, and other professionals are including case management in their role with patients in order to provide efficient service. Regardless of professional background, case managers use a patient-centered and strengths-based approach. Effective engagement puts the patients’ needs first and identifies the most beneficial resources available.

Professional case managers take on many responsibilities in their pursuit of improving patient outcomes. They take the patients’ beliefs, interests and values into consideration, while evaluating how to best support their desired goals. After conducting a needs assessment, case managers will determine how to best serve the patient. Planning and implementation stages are crucial in moving forward with completing and evaluating achievements.

Additionally, advocating for patients is at the forefront of case management, and is included in every component of the case manager’s intervention. Case managers have the ability to foster relationships with patients, while providing resources that best meet their needs. Patients may have complex circumstances, and this warrants a more comprehensive approach to address the whole person.2

The Value of Case Management

Overall, interventions have a positive impact on cancer patients and gives them the tools they need to overcome challenges and improve outcomes.4 When considering financial burdens, for example, patients often report that including case management services was successful in easing anxiety related to costs.5

Case management improves patient quality of life,3,4 and increases empowerment and self-efficacy.3 Cancer patients may face stressors that negatively impact their psychosocial, financial, physical or social functioning. These risks are even greater if a patient is isolated and without support. These effects can be overwhelming and long term. Including case management helps patients return to prior levels of functioning.

Health inequities are examples of other barriers that can adversely effect a cancer patient’s experience. Case managers must make it their priority to address these heath care disparities. This is accomplished by developing methods to either eliminate or minimize the impact they have on their health care.6Case managers can promote policies that support equality, fight for patients’ rights and facilitate communication to be a strong advocate.

Facing Health Care Disparities

All health care professionals must demonstrate a culturally competent and inclusive practice to effectively address disparities. This can be done through the creation of a safe environment, free of judgment and oppression. We play a critical role in reducing inequalities and overcoming barriers to care for all people regardless of race, ethnicity, age, socioeconomic status, ability, gender identity or sexual orientation. Case managers strive to support all efforts to advocate for cancer patients and find resources that are culturally and linguistically appropriate.

A well-rounded approach to case management in cancer care will ultimately benefit the patient in a variety of ways. An experienced case manager includes strategies to address barriers and disparities in all aspects of their work. Incorporating these skills will promote better coordination of care and access to resources, while improving the patient’s ability to cope with cancer. With these objectives in mind, case management will continue to have a significant role in meeting the needs of patients.

Marissa Fors is Director of Specialized Programs at CancerCare.

Founded in 1944, CancerCare is the leading national organization providing free, professional support services and information to help people manage the emotional, practical and financial challenges of cancer. Our comprehensive services include case management, counseling and support groups over the phone, online and in-person, educational workshops, publications and financial and co-payment assistance. All CancerCare services are provided by master’s-prepared oncology social workers and world-leading cancer experts.

References

1. Commission for Case Manager Certification. Definition and Philosophy of Case Management https://ccmcertification.org/about-ccmc/about-case-management/definition-and-philosophy-case-management. Accessed on June 21, 2021.

2. Harkey J. Case management at the intersection of social work and health care. Social Work Today. 2017:17(1) 20

3. Scherz N, Bachmann-Mettler I, Chmiel C, et al. Case management to increase quality of life after cancer treatment: a randomized controlled trial. BMC Cancer. 2017:17(1):223. doi:10.1186/s12885-017-3213-9

4. Yin YN, Wang Y, Jiang NJ, Long DR. Can case management improve cancer patients quality of life?: A systematic review following PRISMA. Medicine (Baltimore). 2020;99(40):e22448. doi:10.1097/MD.0000000000022448

5. Wu C, Bannister W, Schumacker, P, Rosen, M, Ozminkowski, R, Rossof A. Economic value of a cancer case management program. Journal of Oncology Practice. 2014: 10(3): 178-186. doi: 10.1200/JOP.2014.001384

6. Young M. Case managers can ease health inequities and barriers to care.Relias Media. 2019. https://www.reliasmedia.com/articles/144745-case-managers-can-ease-health-inequities-and-barriers-to-care. Accessed on June 21, 2021.