A Look Back Can Help Set The Future Of Case Management

A Conversation with Nell Ann Peck Wooldridge and Mindy Owen, Founding Members of CMSA
anne llewellyn

nell ann peck wooldridge

mindy owen

2020 marks 30 years of conferencing by the Case Management Society of America! To celebrate, I connected with the first two presidents of CMSA to gain insight into the history behind the organization, the purpose of the Annual Conference and what these two leaders think of where the practice is going. Let’s look at what they shared.

Anne: Tell us a little about how CMSA started.

The start of CMSA began with “good old fashion networking”! Nell Ann shared that she was working at Blue Shield of CA and was introduced to a marketer from Abbot Labs, which was based in Chicago. After talking to her for a while about the work she was doing, Nell Ann said, “I wish I knew others who were doing this work so we could collaborate.” The representative said she traveled across the United States and would keep their conversation in mind and let her know if she found others who were doing what she called “case management.” Nell Ann thanked her but really did not think much more about the conversation.

Nell Ann said people started coming together around 1984 as the AIDS epidemic was starting in San Francisco. People were seeing things happen to young men that they had not seen before and knew they needed help. So nurses and social workers started reaching out to each other to see how people were managing their cases. Nell Ann said the term the Lone Rangers came to mind.

Mindy and I agreed that that experience is similar to what we are experiencing today with COVID 19. What is different is that today we have the internet, and professional organizations are sharing best practices and supporting each other as we work through barriers and challenges. Mindy shared that she is impressed with how case managers are taking a lead and transitioning into “crisis managers” and helping to coordinate care and move those patients who can go to a lower level of care or home and allow those who need hospitalization to have a bed and be cared for. Case managers are thinking “outside the box” and looking for new resources so they can transition patients despite new and routine road blocks. We all marveled at how history repeats itself!

Mindy shared that she was working at Intracorp in 1985. Intracorp was a large case management company. She was a care coordinate in the workers compensation division based in Chicago. The leadership at Intracorp saw the value in the work Mindy and the workers comp team were doing and thought that they could move the same process over to the healthcare side. Mindy was asked to lead the development of this “new division” as the first Midwest Regional Director of Case Management. Mindy recalled one day getting a call from a gentleman who said he was from the Hill Group. He had gotten her name from someone who was familiar with the work she was doing at Intracorp and wanted to invite her to a meeting with others to discuss the work they were doing and look at ways to collaborate. As the meeting was going to be held in Chicago, she agreed. Mindy thought that the impetus for the gentleman from the Hill Group to bring the group together might have come from the Abbot representative that Nell Ann met a few years ago, as Nell Ann was also asked to attend the meeting. She flew in from California along with her sister Geri, who was also working in the same arena. A few other people (13 in total) were also invited to attend. The meeting was led by the Hill Group, an association management company, who guided the discussion. As each person shared their stories, it became clear that their success was happening because a dedicated professional was involved, who worked with the healthcare team and thought “outside the box” to address challenges and roadblocks they encountered with the patients they cared for. They all knew they were saving healthcare dollars, but more importantly they were improving care coordination, decreasing fragmentation and helping people who were very sick transition through the healthcare system and get back to their lives.

Anne: Tell us what happened as the meeting progressed. Mindy said that the representative from the Hill Group saw the synergy that was forming and asked the group if they wanted to formalize into something bigger that would allow them to bring others together, learn from each other and put a name to what they were doing. All agreed that this was a good idea. They discussed how they wanted to come together as like-minded professionals, to share ideas and improve the work they were doing so it could spread into other sectors because they knew what they were doing was making a difference.

The Hill Group said that they would work with them to become a professional organization as their association management company. They asked each person at the table to put in $65.00 to retain their services. We all wrote personal checks as we believed that this organization would not only improve the practice of case management but would improve the services we provided to patients and families. Discussion ensued about the structure of the group, what their mission would be and what the name would be. The term “case management” was decided on as Nell Ann recalled someone saying social workers were using the name of case management and it seemed to describe what we were all doing.

The group tossed around several terms like organization, association and society. They agreed on the word “society” because they felt the term would invite various disciplines to participate. Mindy said it was interesting that we said this as all who were at the table were nurses but agreed that case management should not be exclusive to nurses as other disciplines could and were doing the work. Nell Ann said she “volunteered” to be the president. As a result of this meeting, the Case Management Society of America was formed. The Hill Group was the first association management company who helped the leadership understand how to move forward. It was an exciting time.

Anne: How did the idea of a national conference come to pass? Nell Ann recalled that the first conference did not take place until 1990. Prior to this, people networked in small groups in their states and communities. Over time we started to grow the society by having membership dues and local chapters. We felt that chapters were the best way to go as healthcare is local.

Mindy said that the first conference was held at the Pan Pacific Hotel in San Diego, California. Marci Auerbach, a social worker who was a member of the founding board, agreed to be the conference chair. Mindy shared that Marcie had a great leadership style that enhanced the board. The Hill Group had experience of putting a conferences on as they did this in other industries, so they did the heavy lifting and Marci worked to put together the agenda and invited various professionals to speak.

Mindy recalled that when they put the conference budget together, they thought if they could get 100 people to attend this conference, they would break even. Everyone was blown away when 300 people signed up. Mindy attributes the success of that first conference to Nell Ann and her connections throughout California and to some of the sponsors who were learning about the Case Management Society of America and spreading the word on this new society.

Anne: What was the goal for the first conference? The goal for the conference was to bring professionals together to share what they were doing in their companies, both hospitals and managed care organizations. It was exciting to see the ways case management was being seen and having an impact.

Another goal was to find a way to financially support the organization and start serving the members by bringing them educational opportunities so they could stay up to date on trends happening in the industry. Sponsors were learning who case managers were and realized they could be influencers who could help spread the word on what products and services they had. The Hill Group helped the board understand how to bring the various stakeholders together to meet all of the objectives they wanted to accomplish. I smiled to myself as I listened to Nell Ann and Mindy talk and realized that what they did in those early years set the path for the CMSA we know today.

Anne: As you look back over the past 30 years, are you pleased where the society is today? Nell Ann shared that she did not envision the society growing as it has. She thought it would be more an educational endeavor. Mindy agreed that she never put a number to it or ever thought how big the organization would grow. She goes back to that first meeting when those seated around the table wanted to bring together a group of professionals who were all-inclusive to share, grow and celebrate the work they did in their individual organizations.

Both shared that to some degree they are disappointed because there are so many different organizations that it has caused fragmentation of the case management industry. As a result, we do not have the full effect of what we could have if we all spoke with one voice.

Nell Ann shared that another reason the society was formed was to answer tough questions that were being asked in various settings. She said sometimes the tough questions are asked in an accusatory manner vs. a way to seek information. She and Mindy both agreed that things got a little rough at times as the board tried to meet the expectations of so many people. The national board worked to make sure the society kept up to meet the demands of the industry. I think the current board of CMSA would agree that meeting the needs of a multidisciplinary membership is still a challenge.

Anne: What are your hopes for the future? Nell Ann said that she hopes the Case Management Society of America continues to provide resources to members, so they have the education and skills to lead and educate in these changing times. Today, case managers must be teachers and educators for patients and their families who are sicker than ever and are being asked to do more on their own that they are prepared for. Case managers are the ones who can make sure that people are prepared for what the healthcare team is asking them to do by knowing the resources and aligning the patient/family to those resources. Case managers work with the healthcare team to find the best plan of care to meet the patient’s goals and to find the resources they need as they move through their journey. No one else is positioned to be doing this in the same way as the case manager.

One example to illustrate this need is the recent trend where those with end-stage renal disease are now receiving dialysis in their home. We never thought we would see that. But as this trend is implemented, case managers are in place to facilitate the plan with the team to make sure that the transition is safe and appropriate.

Nell Ann shared that she has wondered over the years if we as a “Society” were slipping or have we kept up with the basics of what the original mission was: service to others and keeping the risks down for ourselves. Now that we are in the midst of this pandemic, we are seeing the flaws of our healthcare system. It is so important that we go back to those basics tenets and make sure our practice is following the Standards of Practice and the ethical principles that guide our practice.

Mindy agreed and shared that by following the basics of our practice, we will do the work that effects change and allows case managers to meet the needs of the patients at risk. Each urged that all case managers take the time to revisit the Case Management Standard of Practices, the ethical principles and the Code of Professional Conduct.

The Case Management Society of America has withstood the test of time. Today we are embarking on a new frontier that we will see as we move into a post COVID-19 world. Case managers need to stand together as we look at what worked and what didn’t and work with the various stakeholders and make changes where necessary. Today we need to be united globally. As a result of technology, we have the opportunity to reach out to colleagues around the globe to learn what they are doing and how they meet the challenges they face. Sharing this information allows us to grow and improve the work we do.

At the writing of this article, we don’t know if we will be celebrating 30 years together in Boston or individually in our homes and organizations. Whatever happens, take time to celebrate the work you do and the value you bring to the patients, their families and the teams you work with. Congratulations and best of luck going forward.

I thank Nell Ann and Mindy for their time and for sharing this information and for their continued commitment to case management!

Nell Ann Peck Wooldridge, RN, BA, MS, FCN, is the founding president of CMSA. She served form 1991-1992: Nell Ann is living the good life in Napa, California. She is active in her community and keeps up with family, friends and colleagues. She stays up to date with the practice of case management by reading CMSA Today and other publications.

Mindy Owen, RN, CRRN, CCM, founding board member and president, 1992-1993, lives in Groveland Florida with her husband Bill. She works as an interim director of case management, writes, speaks and continues to share her insights through articles and webinars.

Anne Llewellyn, MS, BHSA, RN-BC, CCM, CRRN, president, 2003-2004, lives in Plantation Florida with her husband. Anne serves on the editorial board of CMSA and works on various programs that give her purpose. She also is a mentor and writes a blog, Nurses Advocate.


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