Creating a Preferred Future for Case Management in the Age of AI

Emerging technologies, particularly artificial intelligence (AI), are reshaping how healthcare is delivered, coordinated and experienced. We are living in a new era of intelligent technology—where AI-driven tools, predictive analytics and virtual care platforms are becoming integral to healthcare.

This technology is significantly impacting the practice of professional case management as well, enabling case managers to streamline workflows, optimize assessment and care planning through data-driven insights and deliver more personalized care to patients.

However, the rapid integration of technology also raises critical questions:

• What does the application of AI and digital technologies in case management mean for our profession in the long run?
• How do we shape a future that prioritizes the foundational principles of case management practice?
• How can we preserve the core principle of compassionate, ethical and patient-centered care as technology continues to advance?

To thrive in this evolving landscape, case managers must proactively shape a future where technology enhances the human connection central to our profession. This article describes the essential characteristics of this preferred future and explores recommended approaches to help shape this future where technology enhances—rather than diminishes—the humanistic practice of case management.

DEFINING A PREFERRED FUTURE

As AI-driven technologies quickly evolve, the future of case management must be intentionally shaped—not merely reacted to. The integration of AI in case management presents a transformative opportunity to create a preferred future—one where technology enhances, rather than replaces, the human connection. In other words, our profession’s preferred future is one in which conscientious case management practice is the standard, not the exception.

Conscientious case management practice refers to a deliberate, ethical, thoughtful and person-centered approach to coordinating care, ensuring every action supports the best possible outcomes. It involves the intentional and thoughtful application of professional standards of practice, ethical principles, professional judgment and evidence-based practices to ensure high-quality care and effective patient advocacy.

The defining features of case management’s preferred future are deeply aligned with the core drivers of conscientious practice. Thus, the envisioned characteristics of case management’s preferred future in the era of intelligent technology include:

1. PROMOTING PERSON-CENTERED CARE

At the heart of case management is the human connection. Case management’s preferred future preserves this relational foundation and ensures care that is tailored to the individual’s needs, preferences and values. Digital tools serve as enablers of efficient, personalized care coordination. Patients are active participants in their care, supported by case managers who utilize AI insights to create personalized care plans.

2. SUPPORTING COLLABORATION AND INTEGRATED CARE

Meaningful collaboration among all stakeholders—including case managers, healthcare providers and the individuals they serve—is foundational in case management’s preferred future. Digital platforms play a vital role in supporting this collaboration by eliminating silos and fostering seamless integration across care teams. Through shared data systems and real-time communication tools, care teams can coordinate more effectively, align around common goals and deliver a more connected, person-centered care experience that drives better outcomes.

3. ENCOURAGING TOP OF LICENSE PRACTICE

In case management’s preferred future, AI and digital technologies are enabling tools used to enhance and support the professional expertise of case managers. Tools such as predictive analytics and virtual communication platforms are designed to reduce administrative burdens and streamline routine tasks. This enables case managers to dedicate more time to high-value, meaningful and fulfilling activities like patient engagement, care planning and advocacy. Ultimately, technology enables case managers to practice at the top of their license and do what matters most: build meaningful relationships that foster trust, promote advocacy and empower individuals on their care journey.

4. ADVANCING DATA-DRIVEN AND EVIDENCE-BASED PRACTICE

Real-time data and evidence-based practices are essential to delivering proactive, person-centered care in case management. By leveraging data and analytics, case managers can identify risks early, customize care plans to individual needs and monitor outcomes to drive continuous improvement. However, data must be thoughtfully interpreted and applied within the context of each individual’s unique situation. In case management’s preferred future, the use of real-time data, predictive analytics and evidence-based protocols strengthens decision-making but is always grounded in individualized care.

5. ADVOCATING FOR EQUITY, ETHICS AND INCLUSION

In case management’s preferred future, an unwavering commitment to equity, ethics and inclusion is imperative. As healthcare becomes increasingly digital, it is critical to ensure that advancements in AI and technology do not intensify existing disparities, but instead are used as tools for closing gaps in care and improving access for all. The conscientious case manager plays a vital role in advancing this future by upholding ethical principles and adhering to professional standards and codes of conduct.

6. ENCOURAGING CONTINUOUS LEARNING AND ADAPTABILITY

Professional development and flexibility are essential to navigating an ever-evolving digital healthcare landscape. As technology advances and care models shift, case managers must remain committed to professional growth and lifelong learning. Case managers will need to stay informed about emerging technologies, best practices and evolving industry trends to remain meaningfully effective in their roles. Case management’s preferred future requires intentional investment in building change management and digital literacy skills, while supporting career pathways that evolve alongside the demands of a digital health environment.

These six characteristics illustrate that the preferred future of case management is not shaped by technology alone, but by how technology is thoughtfully and intentionally integrated into practice, guided by our professional standards of practice. Taken together, these characteristics help strike a balance between the art of human-centered care and the science of technology-enabled solutions in professional case management.

ACTION STEPS TOWARD OUR PREFERRED FUTURE

Achieving the preferred future for case management requires more than visionary thinking—it involves intentional strategies. As technology and AI-driven tools rapidly transform healthcare, case managers must remain firmly anchored in professional standards of practice while embracing the opportunities these technologies present.

To shape the future of case management, case managers and their leadership teams can take the following actions to remain grounded in professional practice in the age of intelligent technology:

TO PROMOTE PERSON-CENTERED CARE

• Appreciate where digital technologies may fit into a patient’s healthcare journey.
• Provide individualized education to help patients understand how technology is used in their care and treatment (telehealth platforms, online portals, biosensor wearables remote monitoring, etc.).
• Assess for and promote digital health literacy to empower patients to confidently access, understand and use digital health tools.
• Recognize that digital tools help patients to engage in their care in a way they value and prefer.

TO SUPPORT COLLABORATION AND INTEGRATED CARE:

• Share case management expertise and collaborate as a subject matter expert with technical teams on implementing digital solutions.
• Ensure all care team members are aligned with patient care plan goals and interventions involving digital health tools.
• Serve on digital health committees, policy development teams or innovation task forces to influence how technology is used to support case management programs.

TO ENCOURAGE TOP OF LICENSE PRACTICE:

• Prioritize digital tools that streamline administrative tasks, support care coordination and strengthen human connections.
• Use AI-driven tools for non-clinical tasks, freeing time for meaningful patient interactions.
• Apply clinical judgment to interpret and act on AI-generated risk scores, care gap alerts and predictive model referrals, ensuring personalized, patient-centered interventions.

TO ADVANCE DATA DRIVEN AND EVIDENCE-BASED PRACTICE:

• Use AI-powered predictive models to analyze data for predictive insights, helping to identify risks and opportunities for early intervention.
• Apply continuous quality improvement (CQI) strategies to regularly evaluate AI-guided programs and make data-driven adjustments to enhance effectiveness.
• Regularly collect feedback from patients and staff to refine AI-assisted processes and interventions.

TO ADVOCATE FOR EQUITY, ETHICS AND INCLUSION:

• Promote policies and standards that protect patient privacy, ensure equitable access to care, and guide responsible, unbiased and transparent use of AI and technology.
• Proactively address the digital divide by mitigating barriers to digital health literacy.
• Provide technical teams with feedback on data validity and underlying assumptions to proactively address potential bias.
• Remain vigilant in advocating for marginalized populations, especially when potential algorithmic bias, data inaccuracies or digital inequities arise.

TO ENCOURAGE CONTINUOUS LEARNING AND ADAPTABILITY:

• Recognize and address personal knowledge gaps to enhance understanding of and confidence in digital technologies.
• Learn about AI and digital technologies used within case management processes to operate from an informed point of view.
• Be open to fresh perspectives and imagine new ways of getting things done using digital solutions.
• Take advantage of education and training opportunities focused on digital health competencies to develop essential skills, adapt to emerging technologies and stay current on best practices in digital health.

FINAL THOUGHTS

The phenomenal growth of artificial intelligence and digital technologies in healthcare presents a defining moment for the future of professional case management. By intentionally shaping a preferred future, case managers can ensure that technology enhances their practice while supporting our professional standards of practice. Realizing this vision will require the responsible integration of digital tools, ensuring that the heart of case management—ethical practice, patient engagement and individualized support—remains central in an increasingly digital healthcare environment.

Mary Beth Newman, MSN, RN, CMGT-BC, CCM, FCM, has 40 years of professional experience in healthcare and case management. Prior to retirement in 2024, she was a senior assistant vice-president at EXL Health, providing consultative case management expertise to support business development for digital/AI initiatives and clinical operations. Mary Beth also has extensive experience in health plan care management operations spanning commercial, Medicare and Medicaid populations. Mary Beth is a past president of CMSA and was awarded a Fellowship in Case Management (FCM) from CMSA in 2023 in recognition of significant contributions to professional case management practice.

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