Promoting Successful Outcomes in Making Care Primary: The Role and Value of Case Management

In alignment with the CMS Making Care Primary Model's overarching objectives, this paper highlights the critical role of case management and professional case managers (PCMs) in augmenting care coordination and patient outcomes across primary care organizations and providers. It describes the characteristics of a successful context of case management practice based on the three Tracks of the MCP Model, PCMs’ role responsibilities supporting care interventions for people with multiple chronic conditions and HRSNs, and application of the Case Management Society of America’s (CMSA) standards of practice - all in primary care settings. This paper also provides key evidence-based information demonstrating potential value for the MCP Model and guidance for key strategies that primary care organizations and providers are encouraged to adopt.

The main objective of this paper is to educate the CMSA membership, PCMs, providers, and other healthcare leaders and professionals about the MCP Model and the role and value of case management in primary care settings. These case management professionals can also use this paper as a blueprint to advance participation in opportunities like the MCP Model, to enhance existing primary care case management practices, and to establish contexts of care that affect better outcomes for both patients/families and health organizations.