Which item is not one of the three functions of integrated CM?

• A. Track patient self-management
• B. Tend/track population management
• C. Reimbursement optimization
• D. Reporting, monitoring quality

Answer: (C)

Integrated case management focuses on coordinating care for individuals and populations and tracking outcomes to improve quality. The three core functions you’ll see are: supporting and tracking how patients manage their conditions (self-management, adherence, action plans); tending to and tracking population management (identifying at-risk patients, coordinating services across providers, ensuring appropriate care); and reporting and monitoring quality (collecting data, measuring performance against quality metrics, and using dashboards to drive improvements). Reimbursement optimization sits outside these care-coordination goals; it’s primarily about billing, payer contracts, and revenue-cycle processes. So the item that isn’t one of the three main integrated CM functions is reimbursement optimization.