By Ellen Fink-Samnick DBH, MSW, LCSW, ACSW, CCM, CCTP, CRP, FCM
The industry is buzzing around reframing word use in response to recent Executive Orders (EO) and other actions by the Federal Government (Federal Register, 2025). Most of the shifts have come as federal agencies interpret how to best comply with EOs that solely recognize two genders (e.g. male and female) or eliminate diversity, equity, and inclusion programs. Other terms have been added by agencies and departments that had little to do with the EOs but were deemed to be concerning. These changes have been particularly difficult for case managers, their organizations, and programs to reconcile and for multiple reasons.
Amid this shifting landscape, case managers and their organizations must reconcile changing longstanding terminology. I was recently approached at a conference to share strategies and resources for the workforce to address our true priority, every case manager’s professional ethical and legal obligations to patients, their families, and the workforce. This blog is in direct response to that request
What’s the Challenge?
It is an understatement to say that working around the words can be complicated. Case managers are used to constant changes in their world, whether regarding legislation, regulatory requirements, and other reimbursement adjustments. Yet, it becomes tougher when the words at issue are aligned with legal or organizational priorities as in accessibility, accommodation, inclusion, or vulnerable populations. What happens when the words are commonly used in daily language, such as advocate, expression, gender, or status. What about when the words are embedded as legal and ethical mandates within state practice acts and continuing education requirements for healthcare professionals as in cultural competence, implicit bias, oppression, or discrimination. There has been critical concern that removal of some words has meant eliminating populations, persons, and their identities as in gender-affirming, LGBTQIA, trans, or other terms. This action is counter to our profession’s ethical tenets of autonomy, fidelity, and nonmalfeasance. On top of all the priorities faced by case managers, the workforce is navigating a new norm, of having to work around the words.
What’s New on Case Management’s Watch
The explicit intent of the Federal focus is to promote healthy communities for all Americans so they can live healthier lives (CMS, 2025) However, recent shifts in federal funding and programming have many individuals worried that not all Americans are included in this action. Four value-based care models were cancelled in March including Primary Care First, End Stage Renal Disease Treatment Choices, the Maryland Total Cost of Care, and the highly-anticipated Making Care Primary model (AHA, 2025). These programs were geared to enhance care access, for millions of Medicaid and Chips recipients and Medicare beneficiaries with complex, costly chronic illnesses. The primary and specialty care practices and providers caring for these populations were expected to reap financial reward with increased reimbursement.
Joint Commission has reframed their highly Health Equity Resource Center to reflect new verbiage; initially changed to Optimal Health Care Delivery for All, the site has now shifted to Excellent Health Outcomes for all (Joint Commission, 2025). CMS’s Health Equity Framework has been reframed as CMS’s Framework for Healthy Communities (CMS, 2025). In addition, their Health Equity Index used for Medicare Advantage Star Ratings has been rebranded as The Excellent Health Outcomes for All Reward (EHO4all) (Emerson, 2025) Concern exists for the future of the industry’s coveted 1115 waivers and other programs that support marginalized communities, though only time will tell their fate.
Strategies and Resources to Heed Case Management’s Professional Obligations
Actionable strategies must be implemented that heed our ethical obligations as healthcare professionals and providers. Advocacy for all patients and their families must continue, so that they receive access to the highest quality care available. This care must still be delivered in a fair and equitable way.
My daily dialogues with valued colleagues are a reminder to prioritize ourselves and our energy. These interactions equally empower our attention to the critical work at hand. Here are five strategies to work around the words within your case management world:
- Stay informed of Current data: Everyone should bookmark a list of valuable resources. Several of my favorites include:
- Monitor and stay on top of case management’s established resources of guidance:
- Regulations that underlie your professional licensure and the scope of that practice across any state(s) in which you are licensed
- Organizational accreditation requirements specific to case management practice, including health equity accreditation programs under NCQA and URAC, and DEI requirements under Magnet Recognition (Bryant et al., 2022).
- Case management and other relevant certification standards and professional codes through your credentialing entity, whether CCMC (2023), CDMS (2023) or others.
- Don’t get lost in the alphabet soup of verbiage: Focus on actions to keep your work current. This may mean using alternative words or language, as posed in the list provided by the Federal Grant Trigger Words Replacement Workbook
- Read What Matters to You Most: Many have reached out to inquire if Federal protections remain in place regarding DEI. The 4/3/25 document published by the EEOC and DOJ, What You Should Know About the Recent DEI-Related Discrimination at Work is an informative read.
- Don’t silo your efforts: Continue to discuss and strategize with colleagues who share your passion and provide you reliable information. Those relationships and conversations will nurture and motivate your efforts.
In the end, our actions matter most to achieving the industry’s quality north star of the Quintuple Aim: patient- and family-centric care delivered at the right time, for the right cost, delivered by those who embrace the work, and assuring equitable access for all. Shifting words should not negate our professional commitments and obligations to the patients and families we care for or the colleagues we work with.
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BIO: Dr. Ellen Fink-Samnick is an award-winning industry entrepreneur whose focus is on competency-based case management, interprofessional ethics, wholistic health equity, quality, and trauma-informed leadership. She is a content-developer, professional speaker, author, and educator who is a faculty member, academic advisor, and IRB coordinator for the Doctoral of Behavioral program at Cummings Graduate Institute of Behavioral Health Studies. She is also an adjunct faculty member at George Mason University’s School of Public Health. Dr. Fink-Samnick is a member of the Professional Case Management Journal editorial board and editor of the journal’s HeartBeat of Case Management department. She also serves in national leadership and consultant roles across the industry, including as current Vice-Chair for CMSA’s DEIB Core Committee. Further information is available on her LinkedIn Bio or her website