How Caseload Size Impacts Care Managers and Patient Outcomes

The pandemic landed particularly hard on healthcare professionals. A study by the American Medical Association noted 63% of physicians had symptoms of burnout in 2021. Further research detailed the impact in terms of a growing nursing shortage. Across the board – from hospitals to imaging centers to clinics to urgent care facilities – the field faces a staffing problem, impacting care everywhere. 

Further, such a state of affairs places additional stress on those workers remaining, including care managers. As an important part of the provider team, care managers are responsible for creating personalized care plans for patients, including identifying social determinants of health (SDOH). The care plans they design address SDOH so patients receive the best care possible and see improved health outcomes. In particular, the size of care managers’ caseload has far-reaching implications for both the care managers themselves and the patients in their caseload. 

In this regard, accountable care organization (ACO) leaders can support care managers with the right tools to help them effectively care for patients. Having effective technology can support care managers in flagging high-risk populations and patients. Additionally, some technology can assist care managers in both identifying individual SDOH barriers and improving intervention matching. 

By considering the benefits of supportive technology, ACO leaders can also see improved cost savings, compliance, and health outcomes. Additionally, implementing the right SDOH tools can have a positive impact on building and executing health equity plans. 

CASELOAD SIZE IMPACTS INTERVENTIONS

Here’s what this means in practice. Take Patient A, who has diabetes. She lives in a food swamp with limited access to healthy foods necessary for regulating her insulin levels. Additionally, she faces difficulties attending appointments due to unreliable transportation.

Similar to Patient A, Patient B faces health challenges. He suffers from arthritis and cataracts. His isolation and limited social support significantly impact his well-being. Living alone and having minimal interaction with others due to cognitive decline and physical limitations exacerbates his symptoms, leading to mental and physical deterioration. 

Next is Patient C, who has a history of migraines and works three jobs to support his family. Due to his work schedule, it becomes challenging for him to attend preventive appointments. 

A care manager needs to oversee numerous patient cases like those mentioned above. They can confidently allocate resources to each patient if the number is manageable and with the correct tools. Perhaps Patient A with diabetes receives medically tailored meal delivery service. Maybe the plan for Patient B prioritizes fostering social connections and engagement. The third patient might have the option to receive telehealth visits instead of in-person, which can reduce the burden of traveling.

Those not overtaxed care managers can leverage the resources available to keep the patients in their caseloads as healthy as possible, with an emphasis on preventive measures so they stay healthier longer. 

CHALLENGES OF TOO MANY CASES

Especially amidst the healthcare staffing shortage, many care managers are seeing the impact of larger caseloads firsthand, making tools to support them even more essential. For instance, the care manager may not have as much time to spend per patient, and could miss helpful information, such as the social determinants impacting particular individuals if left to do the work unsupported. 

Not knowing the risk factors has a significant impact on patient health outcomes. Care managers deserve resources to support their patients properly, and ACO leaders can help by implementing effective tools. Given the staffing struggle, technology can play an ever-increasing role in that solution. 

IMPORTANCE OF TOOLS 

In practice, technology can really support care managers. For instance, some technology can help with administrative tasks or gather relevant social determinants of health (SDoH) data on patient populations. With accurate information on the social determinants impacting patients, care managers can judiciously get resources to the patients who need them most. 

In addition, some tools can even support care managers with targeted intervention recommendations curated for each patient. For example, with advanced technology, a platform could flag the social determinants impacting a patient based on where they live. The care manager can then leverage that information to design a care plan and provide that patient with the resources to best improve their health. 

EVALUATE EFFECTIVENESS OF TOOLS 

However, not all tools support care managers equally, though they might look good on paper. As such, ACO leaders should evaluate technology before implementing it to make sure it will help care managers in practice and not just check a box that they leveraged technology to improve their workflows. For example, does the social determinant tool look more locally than a zip code, even within a community? Is the information up-to-date and timely, or is it two years old? Does the tool continuously update with relevant information? Are the solutions tailored for each individual patient, or is a one-size-fits-none approach?

By asking such questions before adopting a tool, ACO leaders can ensure the technology supports care managers in the ways they need. 

IMPACT ON PATIENTS

In the end, such technology should prove a twofold benefit. First, tools can improve care managers’ workflows, helping them navigate the turbulent waters of staffing shortages. And ultimately, doing so should translate to improved patient health outcomes. It all hinges on the quality of the tools.