Case management models: 4 unique evidence-based approaches

Over the years, case management has evolved into a broad and complex set of advocacy, communication, and resource management practices used in health care, social work, and related fields. Case management is a collaborative process that assesses, implements, and monitors the options and services required to meet client health and human services needs.

To best address the different needs of various communities, researchers and practitioners developed a range of case management practices and models. A case management model is a set of guidelines, processes, and procedures case managers use to deliver the appropriate services and care to their constituents.

Different contexts call for different approaches to case management. Therefore, strong case management practices must be carefully adapted to match each client’s needs, constraints, and resources. For example, adults with physical disabilities may be best served by the brokerage model of case management. At the same time, that approach may be irrelevant to children with mental health issues or teens recovering from substance abuse or addiction.

While there is a vast range of case management models, four stand out for their adaptable, evidence-based approaches. As we review each model, consider how it could fit your human service agency’s case management approach to streamline services and support your community.

Building a solid case management approach begins by identifying a foundational model that can be adapted to meet the needs of your specific clients and resources. First, let’s determine the best model for your practice.

The brokerage case management model

The brokerage model is a straightforward approach to case management in which caseworkers attempt to help clients identify their needs and broker supportive services in one or two contacts. This model assumes that a client will voluntarily use needed services once they know they are available and learn how to access them. In this sense, this model works best when a client's biggest challenge is access to and awareness of services rather than availability.

In a brokerage case management model, the social service provider or case manager provides little direct service to the client. Instead, they serve as a link between a client and community resources, focusing on assessing needs, planning a service strategy, and connecting clients with the services they need.

In many cases, a brokerage case management model may place less emphasis on monitoring and measuring outcomes. However, the organization providing case management services in a brokerage model should still coordinate data collection and assessment across service providers. One of the best ways to accomplish this is through an integrated case management solution. 

When service providers and case managers use integrated systems to assess needs, track services, and measure outcomes, they can easily capture important information about their coordinated efforts.

The clinical case management model

A clinical case management model recognizes that many clients face barriers to services that reach beyond simple questions of access. In this model, a clinical care provider, such as a counselor or therapist, serves as the case manager. 

As a clinician, the case manager in a clinical case management model provides direct counseling for a client's individual concerns, including mental health services, addiction recovery support, or treatment for serious or chronic health conditions. When case managers provide clinical services, they have unique insight into the client's needs. This increased level of understanding improves the case manager’s ability to identify needed services and connect the client with formal resources for community service providers.

More significantly, clinical care providers are well-positioned to encourage clients to connect with informal resources such as family, friends, and peers. These connections can increase the client's willingness and ability to follow through with services.

With this model, the clinical case manager can help the client address social, emotional, and mental barriers to services. As a result, a clinical case management model can lead to more successful outcomes for clients who are less likely to engage voluntarily with services and need support over an extended period of time.

The strengths-based clinical case management model

Like the clinical case management model, the strengths-based clinical case management model recognizes the value of community services, family, and cross-agency partnerships. In this model, case managers focus on empowering clients and their families which creates opportunities for growth, education, and skill development.

A strengths-based case management model encourages the client to build and nurture informal support networks while also identifying and accessing formal community services and institutional resources. 

However, the strengths-based case management model steps away from the clinician’s perspective on the client's needs. Instead, it encourages the client to take the lead in identifying their own needs, take ownership of the search for resources and services to address those needs, and view the community as a resource rather than a barrier.

Strengths-based clinical case management models involve outreach, clinical services, advocacy, and robust coordination between case managers and clients. Implementing a program based on this model requires that organizations and agencies support case managers with a robust case management system that can track highly individualized services and capture complex data and metrics.

The intensive case management model

Finally, the intensive case management model is the most comprehensive of the evidence-based models. Used in a variety of fields, this model aims to deliver thorough, high-quality services in a concentrated amount of time. 

While the duration of this approach is ultimately dictated by the needs of each individual client, the goal is to transition them to less demanding services as quickly as possible. Generally, this approach is for clients with the most significant needs, such as severe mental illness or addiction. The intensive case management model uses a low staff-to-client ratio in which case managers share caseloads to offer round-the-clock support and services. 

However, because of its limited timeline, you may find that this model is too intense for some clients. If that’s the case, have a plan ready to adjust to one of the other models.

A final note about case management models

Once you’ve chosen your case management model, determine the best tools and software to support its implementation. When deciding which tools you’ll use, make sure they can adapt to any case management model. 

With Bonterra Program Management’s Case Management solution (formerly Social Solutions), case workers can track a client's progress through programs, see what’s working well, and identify what needs improvement. As a result, you can save frontline staff time, make reporting easy, surface important insights, and have a greater impact on your clients.