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Case Management

Case Management (CM) is defined by the DoDI 6025.20, and DoD Medical Management Guide, Version 3.0 (2009) as, “a collaborative process under the population health continuum, which assesses, plans, implements, coordinates, monitors, and evaluates options and services to meet an individual’s health needs through communication and available resources to promote quality cost-effective outcomes. In the MHS, CM is a key clinical process that supports the ability to provide seamless continuity of care through the coordination of needed services to meet beneficiaries’ health care needs. Case Management reduces fragmentation of care and generates a positive return-on-investment through the promotion of quality clinical outcomes and cost-avoidance of unnecessary health care services.

In May 2007, TMA established three CM focus areas: 1) Policy, 2) Education and Training, and 3) Information Management/Data Sharing. These three areas continue to be the primary focus of our CM efforts. TMA, Office of the Chief Medical Officer, developed interim policy for the implementation of clinical CM in the MHS. Case management web-based and virtual instructor-led training via the MHS Learn platform is also being developed. TMA continues working toward acquisition of an enterprise-wide automated CM tool to help document and track a patient’s individualized care plan. This tool will be used to enhance the provision of CM services to beneficiaries and to support interdisciplinary health team communication across multiple care settings.

For a list of CM resources and additional reading, click here.

“On October 1, 2013, the Department of Defense established the Defense Health Agency (DHA) to manage the activities of the Military Health System. These activities include those previously managed by TRICARE Management Activity (TMA), which was disestablished on the same date. During the next several months, all TMA websites will change to reflect the new DHA. We appreciate your patience during this transition."
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