Focus on Wellness to Improve Health and Contain Healthcare Cost 

Case Management Focus

One of the primary roles of nurse case managers is to contain healthcare costs. To do this, case managers need to be involved with people in helping to educate them about:  

• Adherence to medication/treatment 

• Acute Care reduction of days and unnecessary, avoidable admission 

• Finding and working with their medical team  

• Management of chronic conditions 

• Prevention/wellness/Changing Behaviors 

• Understanding how to use their insurance and healthcare resources 

Impact of Chronic medical conditions on the economy:  

According to the Centers for Disease Control and Prevention (CDC), 90 percent of U.S. healthcare spending is on people with chronic and mental health conditions. These chronic conditions include heart disease, stroke, cancer, diabetes, arthritis, and obesity. An increasing percentage of the population has two or more chronic, high-cost diseases. 

Cardiovascular diseases are one of the most significant contributors to healthcare costs. Heart disease and stroke could affect over 60 percent of adults in the United States by 2050 and reach $1.8 trillion in related expenses. After adjustments for inflation, this would reflect those costs related to cardiovascular diseases triple over the coming decades. 

Other conditions, such as obesity, also drive higher healthcare costs. The CDC reported that more than 2 in 5 adults in the U.S. have obesity. Obesity is correlated with other costly chronic conditions, including heart disease, type 2 diabetes, arthritis, and sleep apnea, just to name a few.  

To move from a sick healthcare system to a wellness-focused healthcare system, all members of the healthcare team, but especially nurse case managers, have to use their education, expertise, and communication skills to educate employers and employees on habits they have developed over the years that raise their risk of getting one or multiple chronic conditions.  

Opportunities for Nurse Case Managers Can Lead 

If you work in a case management company that works with specific companies, ask if your organization has a wellness education program in those companies. If so, ask what they do and how you can be part of the wellness program. If not, as if you can start a project to develop one. This might be a career advancement opportunity to use your skills as a nurse and nurse case manager.  

If you are looking to move into independent practice, working in wellness could open many doors. Employers are looking for people to join their human resource departments or be independent consultants to their companies, bringing in programs that can help their workforce be healthier. 

Sending materials is a good way, but have a nurse case manage in place to education and answer questions is also important.  

Collaborate with other nurse case managers for educational programs in employer groups and your communities.  

All people need Education regarding their health and healthcare. Basic Education can make profound changes in a person's life. Education can help people learn how to change behaviors that can make a difference.  

Look for opportunities to Educate and empower people in the workplace, in your communities, and in schools. You can and will make a difference!  

I hope you will consider the opportunities in wellness to improve your health and the health of people in your communities and workplace.  

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