Medical case management is a combined process of assessing, recommending, planning, coordinating, and implementing various medical services through case managers or patient advocates to promote and ensure quality and cost-effective outcomes along with the best possible treatment and rehabilitation. The medical case management services are delivered through web-based, telephonic, and person-to-person modes and can be used for hospitals as well as home care settings patients. The cases covered under these services can range from catastrophic to short-term disability and independent medical examinations. The companies involved in the medical case management market generally set up collaborations and partnerships with hospitals, specialty clinics, and other healthcare facilities on one end and with employers, organizations, events, and individuals on the other to create a chain of services that can be provided to the latter.
EK Health Services Inc. and Genex Services, LLC – Notable Market Players in the Medical Case Management Market
Leading companies operating in the market have undertaken various organic growth strategies in the medical case management market. The medical case management market is majorly comminuted by EagleOne Case Management; EK Health Services Inc.; Genex Services, LLC; MMRO Inc.; TRIUNE Health Group; PayerFusion Holdings LLC.; GMMI, Inc.; Sierra Nevada Administrators; AXIOM MEDICAL CONSULTING, LLC; and Medical Case Management Group, amongst others. The companies have been implementing various strategies that have helped their growth and, in turn, brought about several breakthroughs and transitions in the industry. The companies have utilized organic strategies such as launches, expansion, and product approvals. Moreover, the market players have also deployed several utilized inorganic strategies, including mergers & acquisitions, partnerships, and collaborations.
Below are the major growth strategies undertaken by the players operating in the global medical case management market:
| Year | News |
| Oct-2021 | Genex, Mitchell, and Coventry announced the creation of their new parent brand, Enlyte. The three businesses have been moving towards unification since the merger of Mitchell and Genex in 2018, followed by the acquisition of Coventry in 2020. |
| Apr-2021 | TRIUNE Health Group and Lombardi Associates announced the absorption of their two privately owned Managed Care companies. After 16 years of providing case management services to the workers’ compensation industry, Lombardi Associates found a home at TRIUNE Health Group. |
| Jun-2020 | EK Health Services, Inc. has earned URAC reaccreditation in case management and utilization management, with perfect scores for both programs. The award of full accreditation pursuant to Case Management, Version 5.2 Program, and the award of full accreditation in accordance with Workers’ Compensation Utilization Management, Version 7.4 Program, both were effective from July 1, 2020, till July 1, 2023. |
| Dec-2019 | Genex acquired CompAlliance LLC, which specializes in workers’ compensation services, including case management, utilization review, and 24-hour nurse triage, among other services. |
