Barbara Fradkin – FLORIDA TODAY

Q: I have been in and out of the hospital with several health issues. My family is several hours away and my doctor recommended care management. Can you explain what that is exactly?

A: Did you know that approximately 1 in 5 Medicare beneficiaries are readmitted to the hospital within 30 days of discharge?

According to, up to 76% of these readmissions might be preventable!

A common reason for readmissions is missed or late follow-up appointments with primary care doctors, for help with patients’ new diagnoses, medications and treatments.

So now, you can understand why your doctor would like you to have care management involved.

Care management is a client-centered approach to caring for older adults, or others with ongoing health issues. Certified care managers work with families to help ensure quality of care and provide answers to questions when families are unsure of next steps.

They help reduce the stress on family caregivers by doing assessments, monitoring their loved one and helping with medication management.

Care managers can be invaluable advocates, educating their clients while powering through the healthcare maze.

If you are hospitalized, the care manager works behind the scenes before you leave.

They gather your medical records, obtain your medication lists, speak to the doctors and nurses and consult on the best discharge plan for you.

If home health is needed, they will make sure it has been ordered before you leave the hospital.

If private duty care is needed to keep you safe at home it will be arranged.

For those heading to short-term rehabilitation, the care manager will make sure everything is set up in advance.

And it doesn’t stop there.

The care manager will then help you start the process of healing and recovery.

Follow-up appointments with your doctor will be made, and the care manager will accompany you to them.

They will make sure you have the correct medications to take and will monitor you to ensure there are no drug interactions.

The frequency of their subsequent visits are determined jointly with the client.

Medicare (or a Medicare managed care plan) does not cover this service.

However, some long-term care insurance policies DO cover care management services. All associated costs are discussed prior to the care manager’s first assessment visit.

Does the risk of going it alone outweigh the cost?

That is a determination only you can make with your long-term health goals in mind.

Come in or call One Senior Place at 321-751-6771 and let’s talk about Care Management.

The 30-minute assessment is free — and so is your peace of mind.


One Senior Place is a marketplace for resources and provider of information, advice, care and on-site services for seniors and their families. Questions for this column are answered by professionals in nursing, social work, care management and in-home care. To submit a question, send an email to or visit One Senior Place, The Experts in Aging at

Barbara Fradkin is a Social Worker, Certified Care Manager and the Director for One Senior Place, Viera.