Generally speaking, the practice of Care Management follows a six-step process. It begins with assessing the client to determine his or her specific needs for care, which is followed immediately by a detailed report of findings, recommendations, and suggestions. That typically leads to a series of conversations with the family and ultimately agreement on expected outcomes. The care management team then launches the planning phase, searching a range of options to find ways to achieve the expected outcomes. Those options are then discussed with the family and the agreed-upon approach put into action, largely led by the care management team. All the while, as the plan is put into place and ongoing thereafter, care managers are continually monitoring and evaluating the effectiveness of the care plan, maintaining constant communication with families.
At times, the care management plan needs to be updated for any number of reasons and the process repeats, this time with the insights and more detailed understanding of the client.