Case Managers in Primary Care: The Case for Collaborative Care

An essential component of the medical home in a primary care pediatric practice is the case manager (CM), who coordinates the care of children with chronic conditions. However, few pediatric offices have CMs on staff, and studies on CMs in primary care are limited. To assess an integrated collaborative care–CM model, researchers randomized eight pediatric practices to provide 6 months of “doctor office collaborative care” (DOCC) or enhanced usual care to children with externalizing behavioral problems.

CM-directed behavioral screening included a standardized, parent-completed checklist and clinical interviews. Of 787 referred children, 321 children (mean age, 8 years) with attention-deficit/hyperactivity disorder (64%) or disruptive behavior…