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Taking the quality journey to the prize of success.

Vol. 15/No. 4 Professional Case Management 177 Mention the word “quality” to people, and the reaction you are likely to get is rolled eyes and closed ears. Although quality is vitally important, the problem is that it is talked about so much and many times no one sees quantifiable results. Without valid measure, quality is in danger of becoming an empty buzzword. Case managers today need to perceive quality as a process, a journey toward tangible and measurable results that demonstrate the positive contribution that case managers make across the spectrum of health and human services. This journey applies equally to organizations and individuals who commit to elevating themselves professionally through evidence-based practice and quantifiable outcomes. Or, to put it another way, quality is the “yellow brick road” that leads to success. It is up to each case manager to take the first step. The quality discussion is particularly relevant today for several reasons. One of the most visible and vocal reasons has been the discussion around national health care reform, which points to the need for quality initiatives that improve the provision and delivery of scarce and costly care and treatment resources. Case managers’ knowledge and competency with regard to the care management process—assessment, coordination of care, facilitation of communication among all stakeholders, monitoring and evaluation, and revision of the care plan as necessary—make us indispensible to any quality initiative or care team. Another significant quality initiative relates to standards and measures for care coordination, which is at the heart of the case manager’s role. The National Quality Forum (NQF) has put forth its “Preferred Practices and Performance Measures for Measuring and Reporting Care Coordination.” Applicable across all settings of care, the NQF preferred practices and performance measures address a three-step continuum that improves care and lowers cost by scientifically measuring health care performance, reporting the results, and using those results to improve care. Each part of the quality improvement process is vital to improving quality in health care. The NQF initiative draws attention to the importance of care coordination that “helps ensure a patient’s needs and preferences for care are understood, and that those needs and preferences are shared between providers, patients, and families as a patient moves from one healthcare setting to another” (National Quality Forum, 2010, p. 1). The practices and measures are also complementary to efforts to improve transitions of care, which, as case managers know, is an area of emphasis throughout health and human services. NQF’s undertaking is to be applauded for drawing deserved attention to care coordination, which is especially important for people with chronic conditions or who receive care in multiple settings from numerous providers. However, to be effective, care coordination must be provided by competent individuals who have the requisite knowledge and skills. As the Commission for Case Manager Certification stated recently in comments on the NQF draft document, the role of the case manager in care coordination must be acknowledged—especially certified case managers who have demonstrated their competence to practice independently. Another significant development is the move by the Centers for Medicare & Medicaid Services to provide payment for care coordination services under CPT codes 98966, 98967, and 98968 for telephone assessment and management services provided by a qualified nonphysician health care professional. This is significant because News and Views