Case Management Center
The Case Management Center (CMC) at Boston Children's Hospital provides a range of patient and family-centered services.
The CMC (formerly known as the Patient Care Coordination Center (PCCC) is made up of nurse case managers and a dedicated support staff.
Our CMC team includes nurses with a variety of backgrounds, including many with advanced degrees in specialty areas such as parent-child health, public health, community health and business administration.
Most are Certified Nurse Case Managers and participate in local and national professional case management organizations. As well, our department includes several liaisons from payer organizations, community health agencies and government agencies.
Our team is divided into two groups:
- Program-based Clinical Case Managers who provide care coordination services, including discharge planning for post-hospitalization services;
- Centrally-based Utilization Management Case Managers who support appropriate use of and access to health care resources at Children's, including work with insurance companies to facilitate coverage of medically-necessary care.
Case management is...
..."a collaborative process that assesses, plans, implements, coordinates, monitors, and evaluates the options and services required to meet an individual's health needs, using communication and available resources to promote quality, cost-effective outcomes."
-- as defined by Commission for Case Manager Certification
- Ensure timely and patient-focused access to medically necessary and appropriate services at Boston Children's Hospital
- Meet regulatory and insurers' expectations for care delivery, reporting, and authorization.
- Ensure that our patients & families have the necessary education, skills and community services to meet their individual health care needs when they are discharged from our hospital.
- Manage care coordination proactively based on a patient's severity of illness and intensity of service need.
- Contribute to improving care delivery and to optimizing resource utilization.