Care Management

Policy Definition: Care management programs apply systems, science, incentives, and information to improve medical practice and assist consumers and their support system to become engaged in a collaborative process designed to manage medical/social/mental health conditions more effectively. Care management aspires to improve individual and population health by reducing the need for expensive, duplicative services. source

Disease Management

Policy Definition: Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant. Care managers can utilize these structured treatment plans to help individuals better manage their chronic disease, maintain and improve the quality of life, and reduce hospital costs. source

Utilization Management

Policy Definition: Utilization management is a set of techniques used by or on behalf of purchasers of health care benefits to manage health care costs by influencing patient care decision-making through case-by-case assessments of the appropriateness of care prior to its provision. source