Effective collaboration between case managers and doctors is essential to ensure comprehensive and well-coordinated healthcare. Doctors provide medical and diagnostic expertise, while case managers contribute their knowledge of various resources, insurance systems, and social support. Together, they can ensure that individuals who are ill or injured receive the appropriate treatment, economic factors are not overlooked, and the healing process is optimally supported and coordinated. 

What does this look like in practice? Based on a shared case, the psychiatrist involved, Dr. Charles-Edouard Rengade, was prepared to answer some questions from XpertCenter case managers Claire-Lyse Jaquet and Isabelle Pellet.

The interview was held in French and highlights the strengths of such a collaboration from a psychiatrist’s perspective.

Some brief details regarding Dr Rengade: He describes himself as a pragmatic psychiatrist who appreciates the benefits of an interdisciplinary approach. He has many years of experience in supporting individuals with illness and has also written several specialist books.

What is your understanding of the term “case management”? “Case management aims to empower the person receiving support and is strongly geared to their resources. The case manager is a trusted confidant of the person affected and some sort of a “voice” for the involved environment. He or she pursues a jointly defined goal with the patient over a limited period. Case management has negotiating skills that are very useful for the person affected. Prolonged incapacity for work can soon lead to the loss of ties to society and the world of work. If timely and appropriate questions are posed, this can be prevented”.

To what extent did collaboration with the case manager and her presence help in the case of your patient? “The involvement of case management enabled various disability insurance measures to be implemented more quickly and issues from the patient’s environment to be addressed, such as difficulties at the workplace. These can have a very strong impact on mental health. The case manager’s commitment helped the patient to view the various causes of stress in a differentiated manner and define her responsibility and scope of action better. The patient is at present gradually returning to working life and regaining her personal sense of balance.”

How do you as a doctor benefit from the presence of a case manager? And how does the patient benefit? “As a specialist, the case manager contributes a different perspective. He or she is able to supplement the medical factors with an assessment of the patient’s broader environment. For patients, the support and presence of a case manager can be a source of creativity. Furthermore, the network is able to position itself better. However, good coordination is important. To this end, the various parties involved should if possible, meet in person.”

Why can it make sense for a case manager to attend a medical appointment? “In order to facilitate coherent treatment by considering the patient’s environment. Case management facilitates the implementation of changes, helps those affected to broaden their perspective and question circumstances. It frequently also has a destigmatising effect.”

When or under which circumstances do you as a psychiatrist think that case management should be deployed?  “Case management is very helpful if the mental health problems are among other things attributable to relationships or the working environment. This can enable psychosocial risks to be brought under control effectively.”

Is there room for improvement? “Case management is still deployed too infrequently. More systematic application would be desirable.”

How can your colleagues be convinced of such collaboration? “Many psychiatrists above all fear the interference of insurers in their treatment. They need to be informed and educated in this regard. In addition, the question of professional secrecy and the disclosure of information concerning patients’ needs to be addressed. It is important for the collaboration to succeed that the patient perceives the relationship of trust between case management and doctor.”

More and more people in modern society are facing various types of burdens that in turn have a negative effect on their mental health and can result in a crisis. Yet despite all adversities there are people who remain tough even in the most challenging situations and come out of crises stronger than before. This ability is what we call resilience. 

Resilience is an interplay of various factors such as surroundings, thinking and personality. But it would be too simple to think of resilience as the new superpower of the autonomous individual. Resilience is a dynamic and lifelong procedure that takes place in the interplay between a person and their surroundings. It can thus vary depending on the sphere and phase of life.  

Resilience is particularly important in situations in which people are confronted with significant stress such as a long absence from work due to illness, an accident or job loss. Our case management can play an important role in exerting a positive impact on people’s resilience in such crisis situations.  

Here are some ways in which our case managers help to strengthen resilience together with the respective environment:  

1. Creation of social support:  

The most important external resource is social support. We help clients to build up a network of friends, family members, therapists and other resources to support them in mastering challenges.    

2. Enhancement of self-efficacy – belief in oneself and one’s own abilities:  

We encourage our clients to recognise, develop and use their abilities and strengths. Strengthening the self-confidence and self-efficacy of our clients serves to enhance their resilience.    

3. Promotion of self-acceptance – accept what cannot be changed:  

Resilient people are able to accept themselves and concentrate on what they are able to influence. We show clients how they can recognise and alter negative thoughts and beliefs in order to improve their ability to accept themselves.    

4. Development of coping strategies:  

We enable clients to develop and practise a range of coping strategies. For example, work structuring and workplace configuration are jointly discussed when returning to work after a brain injury and stress management strategies at work following burnout. This strengthens our clients’ ability to act.   

5. Strengthening of optimism – the positive outlook on life:  

Promoting optimism can improve people’s ability to manage crises. This can be supported within the framework of case management through the development of positive thinking, empowerment to reassess situations and strengthening of a confident attitude.  

Our case managers address the needs and resources of each individual and his or her working environment and jointly build up a support network. We help to identify and strengthen personal protective factors and promote a realistic viewpoint and proactive attitude. We mediate impartially at employer discussions. We aim to support all persons involved in the search for a good solution. In this way, we at XpertCenter Case Management view the resilience of people as a dynamic process and wish to support both the individual and his or her environment in a targeted manner.

Mr P. suffers from a serious illness. That means he is frequently absent from work. The following practical case management example demonstrates that not only was Mr P.’s job kept for him, but he was also sustainably integrated thanks to the involvement of all the parties involved. The case manager played a key role and acted as the central coordination point.  

For many years, Mr P. has suffered from a recurring mental health condition. Previously he had been supported by disability insurance through development and resilience training, as well as through job coaching and with his job search. After a period of unemployment, he started working for his current employer and was again declared unable to work after barely a year and a half, on account of his mental health issues.

As a first step, the case manager conducted an assessment together with Mr P. and discussed the situation with his doctor and psychologist. It emerged that his incapacity was attributable to the same “pattern of events”. Subsequently, the case manager made contact with the employer. She made sure that his job was kept for him and that the employer was supporting this occupational integration process. In a joint dialogue with the clinical professionals and employer, a job trial was planned. Since disability insurance only took over responsibility for occupational integration at that point, the job trial was paid for by the body responsible for daily sickness allowance insurance. Round-table and regular on-site meetings took place. After the success of the job trial, disability insurance got on board with the plan. A job coach providing additional integration assistance at the employer was made available for Mr P. Throughout the process, the case manager acted as the point of contact for the individual involved, the employer, the clinicians, daily sickness allowance insurance and disability insurance. She coordinated the occupational integration and ensured that the information flowed effectively and transparently between everyone involved.

Mr P. was successfully supported with a focus on his long-term integration, and he is currently working in his original position with the same employer. Feedback from both Mr P. and the employer has been highly positive. They greatly appreciated the regular discussions and supportive communications.

Concordia is a long-standing XpertCenter customer. So we thought we’d find out what they thought of our collaboration and ask them about the added value that is unlocked by Case Management (CM).  

How did you hear about XpertCenter and its Case Management services?

We’ve been working for a long time with XpertCenter in the prevention of insurance fraud. It therefore made sense to us to call on the XpertCenter team for our case management needs.

For which customers/clients do you use XpertCenter CM?

CONCORDIA Liechtenstein offers CM to our commercial lines partners who have arranged daily sickness allowance insurance.

Where do you see CM adding value?

CM helps companies to assess and coordinate absences due to illness both efficiently and comprehensively. The goal is to see people return lastingly to work and prevent them for becoming unable to work on health grounds. That’s something that benefits everyone involved.

What’s your experience of collaborating with XpertCenter in CM?

Highly professional, reliable and trustworthy are the words that spring to mind. Both ourselves and our corporate customers in particular appreciate that we always have the same case manager as our contact person.

Would you recommend working with XpertCenter in this area and, if so, why?

Definitely. Our business benefits from XpertCenter’s long-standing expertise and wide-ranging experience.

In your view, which support tasks does CM cover?

• Coordination of benefits between the general practitioner and other medical personnel providing treatment, any social or private-sector insurers and the personal sphere.
• Personal support for the employee on sick leave.
• Neutral contact person for employers.

How do you think CM affects the subsequent stages of a given case (positive developments, clear case guidance, etc.)?

CM is perceived by many people on sick leave as a genuine aid during their convalescence and subsequent return to work. Areas of uncertainty can be discussed though regular contact with the person on sick leave as well as with the employer. Coordination with doctors and the employer allows for the proper planning and smooth execution of their return to work.

Would you like to see extra services offered under CM? If so, which ones?

We’re very satisfied with this collaboration and for now have no further requests.

The case managers (CM) working for XpertCenter each support over 500 people in returning to the world of work.

The well-being of clients and their satisfaction are pivotal to the process. For quality assurance purposes, all persons who are helped, as well as the employers taking them on, are asked to give feedback after each case has been resolved.

This feedback has been extremely positive. Employers appreciate the fact that they can count on a competent, neutral point of contact. They particularly like it that the CMs act as go-betweens for the employer, the employee and the various social insurance offices, which makes life easier for all involved.

Those benefiting confirmed that case managers lift a burden from their shoulders as well as providing timely support. The empathetic help they provide and the fact that they always have a listening ear were regularly emphasised.

Feedback included sentences such as “The support was like a lifeline,” or “The case manager was highly dedicated, professional and approachable”, showing that case management plays a key role in professional reintegration. Feedback also helps XpertCenter get even better at what it does.