I am a professional geriatric care manager in private practice in the north Dallas area. I’ve been in practice officially since 1996 but I’ve been working in the field of caregiving since I completed my Masters in Counseling in 1990. The term ‘Care Management’ is a bit misleading. It is actual profession with a national website, http://www.caremanager.org; I’ve been a member since 1994. Care managers do not do much ‘management’; we may supervise or coordinate care, make suggestions about how to improve an older adult’s situation, counsel with the elder and/or the family, and generally guide the family through the maze that is ElderCare. The term ‘medical system’ is really an oxymoron; there is no ‘system’ of medical care. It is fragmented into pieces, who often do no communicate with each other about the patient’s care or current status. This may be the most valuable contribution care managers make to the overall care of the care receiver. We generally pay for cost by helping the family avoid costly mistakes.