The most common case management models in long-term care include the
brokerage model, the managed care model, and the integrated care model. These three
traditional models of case management share a common concern with helping vulnerable
clients to access services, but differ dramatically with regard to fundamental components
such as the extent of care manager fiscal responsibility, the level of care manager
authority, and the intensity of care management activities.
We recommend that the term “care coordination,” rather than “care management,”
be used to describe the broad continuum of professional and paraprofessional activities
that can be involved in assisting disabled individuals to access services. In accordance
with a suggestion by Challis (1999), we recommend that the term “case management” be
reserved for the intensive set of professional activities associated with ongoing, in-person
contact required by vulnerable individuals with complex or changing conditions. Within the
broad range of activities included in care coordination, the appropriate level and type of
activity will vary depending upon client needs and system characteristics, with only the
most vulnerable clients receiving intensive case management. Clients possessing greater
internal and external resources may only require assistance in identifying and accessing
services, and may not desire more intensive case management.