Understanding The Difference Between Care Managers, Patient Advocates And Case Managers To Enhance The Care Continuum

Life Care management is an often unfamiliar field that is often confused with other professional services. Life Care Management, also referred to as “Care Management”, is a very well-kept secret. Oftentimes people find a life care manager and sigh with relief stating, “why didn’t I know about you years ago”? 

In this month’s blog, we are going to discuss what Care Management is, the value of care management and the similarities and differences compared to case management and patient advocacy.  

Life Care Management is defined in The Life Care Management Handbook as “a field of practice, utilizing educated and experienced professionals specializing in assessment and care planning, connecting to vital services and resources, coordinating care through collaborating, management care and providing professional oversight and helping resolve issues to achieve optimal health regardless of age or ability” (Crowley & Huber, 2021).

Care Managers commonly work in private practice helping individuals and families through holistic assessments, creating plans of care which includes recommendations and linkage to community resources and ongoing support. The Life Care Management Institute created a methodology for Life Care Management to describe this process called “Learn-Create-Manage” (The Life Care Management Institute, 2020).

• Learning includes a holistic assessment to learn all about the client, family, concerns and supports through a holistic assessment.
• Create includes creating a comprehensive plan of care. The plan of care should address areas of concern, goals, barriers to reaching the goal and recommendations in order to meet goals set and overcome barriers.
• Manage includes the ongoing support of the client, family and care coordination in order to achieve optimal outcomes, reach goals and provide the greatest quality of life possible.

How does Care Management differ from Patient Advocates and Case Managers? 

Other professions that are similar and have some overlap include case management and patient advocacy. Although these professionals have similarities, they are different enough to warrant their own field of expertise and practice. 

Patient Advocates

Patient advocates tend to be more medically based. They work with many individuals who have acute or chronic health conditions. Patient advocates help individuals achieve optimal health and well-being. Many, but not all patient advocates, work with client’s medical bills and advocate for cost effective service. Many patient advocates review medical records and are well versed in helping navigate the medical field.

 Case Managers

Case management is typically hospital or physician practice based. Case managers typically work in the medical field and are paid by insurance to help coordinate care, help with transitions, discharge planning or reduce hospitalizations. Case management can be in person or telephonic. A main difference between Life Care Managers and Case Managers is that Case Managers provide a more specific service to get a specific outcome. An example is a case manager in charge of discharge planning in a hospital may do specific education on discharge and follow up. Case management services typically end within a time frame; such as discharge from a hospital. Both Care Management and Case Management services provide referral services, but Case managers rarely follow up for any length of time, versus Care Managers who can be involved with follow up care and ongoing coordination of resources for years.

All three entities do not compete with each other. They are seen in the fields as complimentary services. Here is a case study to help explain the collaborative efforts: 

A client/patient is discharged from the hospital and a Case Manager finds an appropriate skilled nursing facility to provide care. The Care Manager helps with the transition from the skilled unit home and coordinates the community resources to surround the client as well as home modifications for a safe return home. The patient advocate may review the extensive medical bills from the hospitalization and skilled facility. They may also provide education surrounding follow up with specialists, the chronic condition the client/patient is experiencing in order to prevent future hospitalizations. 

One area of overlap is between patient advocates and care managers during physician visits. When both professionals work together to communicate the best approach for their designated role, it can provide a comprehensive, holistic approach that enhances quality of life and provides peace of mind for the client, family and loved ones. 

Being knowledgeable about each individual’s role, helps clients/patients maximize the care teams input. Understanding these differences in roles can even help professionals as well. Many times lines can become blurred and professionals make assumptions about the role other professions should or shouldn’t be playing. When this happens, there can be a lack of communication and awkwardness of not wanting to “step on each other’s toes”.

By being educated about the role that each individual is playing within the care team, professionals are able to see roles clearly and work together in a more cohesive manner; making patient care a true continuum and optimizing their quality of life.