Managing to Care: Case Management and Service System Reform (Social Institutions and Social Change)

In the decades since the Great Society, service sectors as diverse as public assistance, Medicaid, long-term care, and mental health have come to rely on case management to coordinate and rationalize service delivery. Created as a tool for integrating services on the level of the individual client, case management has evolved into a means of rationing resources and controlling costs. Thus a program that began as a service technique has helped to drive the most significant trends in American health care and social welfare, including the entrenchment of bureaucracy, the challenging of once dominant professions, and the rise of corporate control. Managing to Care explains the historical development of case management strategies, assesses organizational and operational issues cross-cutting case management programs in different sectors, and critically examines the popularity of this technique as a dominant mode of service system reform. Dill identifies recurrent themes and tensions in the application of case management through case studies of long-term care, services for people with chronic mental illness, and the public welfare system. By analyzing case management in historical and critical perspectives, she opens to scrutiny aspects of its practice that have often been taken for granted, and identifies new possibilities for its application.