How to Deliver Care Management: Guidance from an Analysis of Communication Patterns in Primary Care

Care management is a patient-centered approach to helping patients and their support systems better manage health conditions. It includes patient education, goal setting, and self-management support. As part of such efforts, the term “care manager” is often used to refer to the activities of a nurse who works closely with patients and their primary care team to help provide chronic care management and coordination during care transitions.

When implemented in a controlled manner—with rigorous training and adequate resources—care managers’ work has the potential to improve chronic condition management and to lower costs. However, evaluations of care managers in the “real-world” have shown that their effectiveness varies, due in part to wide variation in implementation.