Case Management Referral: Indications and Operational Guidance

Primary Indications

Medical Complexity and Instability

Care‑Coordination Needs

Social Determinants and Barriers to Care

Disease‑Specific Indications

Respiratory Disorders

Advanced Heart Failure

[3][4]

Mental Health Conditions

Post‑Acute Care Transitions

Pediatric Populations

Palliative and End‑of‑Life Care

Operational Considerations

Situations Where Referral Is Not Required

Common Pitfalls and Best Practices