What are the goals of CM?

• A. Ensure patients receive quality, cost-effective, safe, evidence-based care in the least restrictive setting
• B. Ensure patients receive care only in hospital settings
• C. Prioritize rapid discharge regardless of safety
• D. Maximize billing opportunities

Answer: (A)

Case management is about coordinating a patient’s care across the entire continuum to ensure they receive high-quality, safe, and cost-effective services that are grounded in evidence and aligned with the patient’s needs and preferences. The emphasis is on placing the patient in the least restrictive setting appropriate for their condition, which means treating them in the setting that enables safe and effective care—whether at home, in community-based services, or in the hospital when necessary—while avoiding unnecessary or overly invasive interventions.

This approach promotes safety, continuity, and efficiency by coordinating across inpatient, outpatient, and community resources, reducing fragmentation and avoidable hospitalizations. It also centers on evidence-based practices and patient preferences, not simply where care happens.

Care that is limited to hospital settings, or that prioritizes rapid discharge at any cost, misses the broader aim of appropriate placement and safety. Likewise, maximizing billing opportunities is not the goal of case management; the focus is on patient welfare and efficient use of resources, with any billing aspects being a byproduct rather than the objective.