By Colleen Morley DNP RN CCM CMAC CMGT-BC CMCN ACM-RN FCM FAACM
There’s something both encouraging and eye-opening about what case managers across the country are sharing about equity in healthcare. A recent national DEIB Client Perspective Survey, with input from more than 300 respondents, paints a clear picture: case managers understand disparities, recognize inequities, and know what their patients need. But there’s a disconnect. Even with that knowledge and commitment, they aren’t always able to deliver the care they know is right. That gap, between knowing and doing, is where the real story lives.
The good news is that case managers are more than ready for this work. Many reported feeling confident in identifying health disparities, advocating for patients from diverse backgrounds, communicating in culturally responsive ways, and delivering person-centered care. These strengths align closely with the Case Management Society of America Standards of Practice, reinforcing what many in the field already believe: equity isn’t new to case management; it’s part of who we are.
But readiness alone isn’t enough when the system doesn’t support the work. One of the most common challenges that came through in the survey was communication. Case managers described delays in getting interpreters, limited access to adaptive communication tools, and inconsistent support for patients with hearing, vision, or literacy needs. These aren’t small issues—they directly affect how well we can connect with patients and coordinate their care.
Structural barriers add another layer of complexity. Case managers shared that their confidence drops when they’re working with patients facing issues like housing instability, immigration concerns, limited insurance coverage, or a lack of community resources. It’s not because they don’t know what to do. It’s because the system doesn’t always give them the tools or options to do it. They’re left trying to solve problems that go far beyond the healthcare setting, often without the support they need.
Workforce diversity also came up as an important concern. Only about a third of respondents felt that their organization’s staff reflects the populations they serve. That mismatch can make it harder to build trust and truly connect with patients. At the same time, while most case managers have had some form of DEIB training, many said it doesn’t always translate into real-world practice. The training can feel too theoretical, too infrequent, and not helpful in the moment when tough situations arise.
One of the clearest takeaways from all of this is that equity can’t rest on individual effort alone. Case managers are doing incredible work every day, often going above and beyond for their patients. But too often, they’re doing it in spite of the system, not because the system is designed to support them. That’s where the real opportunity for change lies.
What’s encouraging is that case managers aren’t just pointing out the problems—they’re offering solutions. They’re asking for practical tools they can use in real time, like scripts, checklists, and decision guides. They want reliable communication resources, including consistent interpreter access and better technology. They’re looking for stronger partnerships with community organizations, more focus on workforce diversity, and ongoing learning that’s built into daily practice—not just annual training sessions. They also want clear ways to address and escalate situations involving bias or inequity.
At its core, this work reinforces something many have long believed: case management is uniquely positioned to lead the way in advancing health equity. But to do that, we need to move beyond good intentions. We need systems, workflows, and resources that truly support the work.
When that happens—when the infrastructure matches the commitment—equity stops being something we talk about and starts becoming something we consistently deliver. And in that space, case managers aren’t just coordinating care—they’re helping drive better, more equitable outcomes for patients across the entire healthcare continuum.
For more on the results of this survey, watch for the companion article in an upcoming CMSA Today.
What's Happening at CMSA in August Summer may be coming to a close, but that doesn't mean your learning has to! Keep the momentum going this month with CMSA's upcoming webinars and events.
Stay current, earn CEs, connect with fellow professionals, and invest in your growth—there's something for every case manager. And don't miss your chance to secure Early Bird registration for CMSA's Leadership Conference this October before rates increase.
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Bio: Dr. Colleen Morley, DNP, RN, CCM, CMAC, CMCN, CMGT BC, ACM-RN, IQCI, FCM, FAACM is the Associate Chief Clinical Operations Officer, Care Continuum for University of Illinois Health System and the current Immediate Past President of the Case Management Society of America National Board of Directors and President Elect of CMSA Chicago. She has held positions in acute care as Director of Case Management at several acute care facilities and managed care entities in Illinois, overseeing Utilization Review, Case Management and Social Services for over 14 years; piloting quality improvement initiatives focused on readmission reduction, care coordination through better communication and population health management. Her current passion is in the area of improving health literacy. She is the recipient of the CMSA Foundation CM Practice Improvement Award (2020) and ANA Illinois Practice Improvement Award (2020) for her work in this area. Dr. Morley also received the AAMCN Managed Care Nurse Leader of the Year in 2010 and the CMSA Fellow of Case Management designation in 2022. Her 1st book, “A Practical Guide to Acute Care Case Management”, published by Blue Bayou Press was released in February, 2022. Her 2nd book, "Practical Guide to Hospital Readmission Reduction =, published by Blue Bayou Press was released in February 2024. Her 3rd book, "Practical Guide to Acute care Case Management Leadership" is in the works, targeting publication in 2025. Dr. Morley celebrates 25 years of nursing experience and 20 years in case management in 2024. Her clinical specialties include Med/Surg, Oncology and Pediatric Nursing. She received her ADN at South Suburban College in South Holland, IL; BSN at Jacksonville University in Jacksonville, FL, MSN from Norwich University in Northfield, VT and her DNP at Chamberlain College of Nursing.