Here is a summary of the key points from Michael Monzer’s presentation, followed by his answers to our subsequent questions.

For Michael Monzer, case management is when cases are selected by the application of transparent criteria for a procedure involving a comprehensive cross-disciplinary assessment of problems and resources, taking into account all relevant sources of information. Based on this assessment, objectives are derived and, in the subsequent planning of support, measures are defined – qualitative implementation of which is ensured by means of performance management, so as to achieve the objectives.

Case management is not the work of a single person. Case management is an approach within a system – an approach designed to support the right people with the right guiding measures, so that they can regain their place at work and in society, and attain as much motivation and satisfaction as possible from the available resources. This entails a relatively long process of counselling and support in cases that cannot be adequately addressed within the framework of existing routines and procedures. It also requires the involvement of many different people.

At V⁠i⁠s⁠a⁠n⁠a, for example, it is up to the case handlers to make the right decisions on the basis of the initial medical documents received, scheduling and managing the processes in such a way that the right policyholders benefit from this management. The treating physician also plays an integral role in case management. Case management involves coordinating the return to work in cooperation with this physician, as well as with V⁠i⁠s⁠a⁠n⁠a’s company physician, who, by means of direct consultations and recommendations, helps the treating physician to better assess their evaluation of the patient’s capacity to work, and to communicate this to the patient.

Case management should be seen as an organisation in which many people play an active role. This organisation needs constant improvement and adaption. It is, so to speak, the heart of the entire organisational unit and cannot be delegated to third parties or outsourced. During further development of case management, it is important to identify individual problem areas and to involve the right people. In addition, when working at case level, it is essential to also keep an eye on the processes and to adapt them where necessary.

Michael Monzer: At our meetings, I was always amazed at how much understanding of case management was already in place. One might think that, given the insurance context, many objectives for individual case work are already predetermined, and that this limits the scope for support. Fortunately, it wasn’t like that.

Instances of case management for V⁠i⁠s⁠a⁠n⁠a policyholders are handled on a cross-departmental basis, which makes it possible to develop solutions that have a more lasting effect. This benefits the organisations and businesses involved, along with their structures, when it’s necessary to establish or adapt alternative support services.

In Germany, management tasks are increasingly enshrined in law or tied to public bodies. This does have the advantage of creating mandatory entitlement to case management, but it often results in heavily regulated implementation.

Case management in Switzerland depends heavily on its specific context. In insurance companies, it can become a defining factor in public healthcare – if implemented with cross-departmental aspirations. It’s a similar situation with hospitals. It often seems to me that case management in Switzerland is dominated by individual initiatives, meaning that there’s still untapped potential for development at regional level, which I see particularly in communal advice centres, as well as in the provision of assistance and care at home.

Political initiatives in Germany aimed at increasing the use of case management are currently characterised in particular by a desire to align the processes of the organisations involved, in other words namely hospitals and care providers, more closely with one another. There’s less and less talk of interfaces. Instead, the focus is on process integration, which requires greater adaptation on the part of the organisations involved.

I think that cross-case system integration holds interesting potential for V⁠i⁠s⁠a⁠n⁠a’s case management work – in inpatient and outpatient care, for example – where the potential stems from lessons learnt in individual instances of case management.

Professor Michael Monzer (born 1957) worked as a project manager, social planner and project planner at the Stuttgart Office for Social Affairs until the end of 2021. As a founding member of the German Association of Care and Case Management (DGCC), he is jointly responsible for the development of the DGCC’s standardised case management training programme. He also co-authored the framework recommendations and ethical standards for the case management action plan. As a certified case management trainer, he has been teaching at various institutions in Germany, Austria and Switzerland since 2003. www.monzer.de