Managed care, Medicaid, case management, HMO, health care policy
Abstract
The employment of social workers within managed care organizations is
a new phenomenon. As such, this case study utilized an exploratory-descriptive
design that assessed social workers as case managers within a Medicaid HMO. The
semi-structured interviews, focus groups, and participant observation suggested
that the use of case management services, delivered primarily by social workers,was
effective in addressing the bio-psychosocial needs of Medicaid consumers within a
provider-driven HMO. Study findings recommend specific knowledge and skills that
social workers need in order to prepare for practice within managed care environments.
