By Catherine M. Mullahy, RN, BS, CRRN, CMM, FCM

Case managers, whose role involves interacting with other members of their patients’ treatment teams, have yet to prioritize forming strategic alliances with other healthcare professionals and providers. Along with supporting better patient outcomes, these partnerships also deliver benefits such as maximizing resources, eliminating redundant activities, and containing costs. Over the years, various professional organizations have spoken about the importance of partnerships between healthcare professionals.  

The National Academy of Medicine discussed the need to involve diverse communities; the American Association of Colleges of Nurses included in its eight essentials for doctoral-prepared nurses “Interprofessional Collaboration for Improving Patient and Popular Health,” and the Commission for Case Manager Certification, which approves various Care Excellence courses for case managers, approved a foundation course titled, “Community Partners,” which focuses on strategies to identify community partners and ways to define partners goals, and use joint task forces to develop resources to benefit patients. Case managers need to understand how their peers are using strategic partnerships, their goals for these partnerships, the value they provide, and how best to build an effective collaboration. 

Partnerships between Case Managers and Other Healthcare and Community Resources  

For case managers, networking and building alliances not only advance their patient care and advocacy but also help support their career advancement. It is often necessary to supplement one’s expertise with another professional or to meet a patient’s needs more quickly. In either case, building a broad network of other professionals, providers, and community resources provides new opportunities and career options for case managers. 

In many hospitals, nurse case manager leaders are expected to develop strategic partnerships that align with healthcare policy development and improve patient outcomes. Still, a Fenninore and Warshawsky study found that nurse managers with over seven years of experience did not believe they were proficient in strategic partnerships and performance improvement. This prevents them from contributing to a healthcare organization’s adoption of new policies and transition toward new healthcare models. Additionally, a nurse case manager leader’s inability to effectively form strategic alliances compromises the ability to address critical public health issues, particularly those most affecting the populations they serve. 

One Example – Building a Partnership with a Hospitalist 

Consider a partnership between an independent case manager and a hospitalist whose primary focus is on the medical care of hospitalized patients. Their roles vary depending upon a hospital’s operating model and the type of hospital they serve. They can, however, be found in many leading hospitals, including The Mayo Clinic and the Cleveland Clinics. 

Hospitalists and case managers share many common goals. These include achieving high-quality care by applying evidence-based medical protocols, applying appropriate clinical interventions to facilitate cost-effectiveness, transitioning patients from acute care settings to other settings, assuring effective continuity of care, and reducing preventable hospital readmissions.  

Building Effective Partnerships 

For independent case managers, building partnerships with other healthcare community members and those involved in other aspects of healthcare (e.g., insurance, third-party administrators (TPAs) of healthcare benefits, disease prevention organizations, etc.) generates new business opportunities. Referrals from TPAs, health insurance carriers, and brokers, managed care organizations, etc., can lead to valuable business referrals. For case managers in healthcare provider settings, partnerships also position them as proactive, engaged in their broader healthcare community, and strong patient advocates. 

Developing strategic partnerships requires a plan that incorporates the following: 

• Specific goals and timelines, 
• Targeted partners with whom to align, as well as responsibilities and expectations for each alliance
• Proposed financial terms, where appropriate and after being negotiated  
• Any restrictions associated with the partnership (e.g., aligning with direct competitors)
• Benchmarking procedures for strategic alliances. 

Forming strategic alliances is in the best interest of all stakeholders – case managers, physicians, nurses, communities, and, most importantly, our patients. These alliances are the foundation of optimum healthcare, supporting the best patient outcomes and experience while advancing broader healthcare goals in terms of population health management, cost containment, and the career satisfaction and retention of skilled healthcare professionals, which our nation desperately needs today amidst massive shortages. 

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Bio: Catherine Mullahy is one of the healthcare industry's foremost leaders advocating higher standards in healthcare case management. With more than 40 years of experience managing health care delivery in critical care settings, emergency rooms, home care and then in case management, her leadership is evident in past roles as President of the National Board of the Case Management Society of America and Chair of the Commission for Case Manager Certification, among other high profile positions. Winner of CMSA's Outstanding Case Manager of the Year award in 1999 and its Lifetime Achievement award in 2010, Mulllahy continues to promote Best in Class Case Management. Her book, The Case Managers Handbook, now in its sixth edition is widely recognized as the definitive case management text and used by more than 65 universities, as well as countless corporations, hospitals and individuals to prepare for the role of case manager and for professional certification. Mullahy's case management company, Options Unlimited was sold in 2003 following 20 years of service to employers, insurance carriers, unions, municipalities and other entities in the private and public sector. As founder and President of Mullahy and Associates, LLC this company now provides consulting, educational and advisory services. The Company's Flagship seminar Best in Class Case Management was the recipient of Case in Points Platinum Award in 2011 and 2014, and is presented to thousands of individuals each year. Designated by the Commission for Case Management Certification in 2013, as its official education partner, Mullahy & Associates has also been presenting the CCM Certification Preparation Workshop nationally.