Structure as location for the care manager

We begin with the location – where the care manager works physically – because we have found this to have such important implications for other decisions about structuring the care manager role. There are three ways in which care management programs are structured for physical location:
1) Off-site care management
2) Co-located care management
3) Embedded care management

Off-site care management

In the off-site structure, the care manager works outside of the practice in a centralized location.
Usually the care manager in this situation works as a support to multiple practices. The care manager may coordinate with an on-site practice team member, and patient visits are conducted via telephone. Off-site care managers may make visits to see patients at the practice or in their homes or other location, but their primary work location is not the practice. Off-site care managers often work for another entity and not the practice.

Co-located care management

Co-located care managers work at several practices, but generally do not work for the practice. Generally, the care manager works for an associated practice association or organization. S/he spends a half-day up to multiple days per week at the practice. The care manager is able to meet with patients by phone or face-to-face while in the practice. In some cases, s/he also travels to meet with patients at their home. There is some integration with the care team, but it is often limited by the care managers not being at the practice on all days.

Embedded care management

Embedded care managers work on-site in the practice and are integrated within the primary care team. The care manager conducts patient visits via telephone and in person. In some cases, but not usually, s/he can visit patients at the hospital and in the home. The care manager works for the practice. A summary of the pros and cons for each of the three structures for care
management appears in the table.

By Complete Care Management, Inc.