Care Management

Care management is a set of activities to improve patient care, reduce unnecessary need for additional medical care, avoid duplication of care, and help patients and their caregivers more effectively manage their health conditions. AHRQ provides data, resources, and research to improve care management of patients with chronic conditions, substance use disorders, and other health problems.

Initiatives

• Primary Care-based efforts to reduce potentially preventable readmissions: This project describes the role of primary care of patients after hospital discharge to reduce potentially preventable hospital readmissions.
• Opioids and Older Adults: This AHRQ initiative focuses on the prevention, diagnosis, and management of opioids, opioid misuse, and opioid disorder in older adults.
• Multiple Chronic Conditions Research Network: AHRQ's research network continues to examine ways to advance the care of patients living with multiple chronic conditions.

Highlighted Resources

• Care Management—An Implementation Guide for Primary Care Practices: This guide, based upon research on successful strategies used in practices with documented outcomes, helps primary care practices implement care management. It also helps new care managers become acquainted with the potential roles they can play on the care team.
• Roundtable Report on Optimizing Health and Function as We Age (PDF, 1.7 MB): Report from the April 14, 2023 roundtable on optimizing the health, functional status, and well-being of the U.S. population as it ages. 
• Report on Potentially Preventable Readmissions: Conceptual Framework to Rethink the Role of Primary Care: Report on the role of primary care in preventing hospital readmissions.
• Technical Brief: Prevention, Diagnosis and Management of Opioids, Opioid Misuse, and Opioid Use Disorder in Older Adults: Technical brief on prevention, diagnosis, and management of opioid misuse in older adults.
• AHRQ Research Summit on Transforming Care of People Living with Multiple Chronic Conditions: Research summit on transforming care of people with multiple chronic conditions.