There is limited research about the impact of community-based case management (CBCM) services and its outcomes with longitudinal analysis. The purpose of this study was to evaluate the effectiveness of a CBCM intervention on patient outcomes in Medicare beneficiaries with chronic illness in a CBCM service in the rural Midwest. A descriptive, repeated-measures design was used, and a secondary analysis of a data set containing longitudinal CBCM data, originally collected from 2002 to 2007, was conducted. Two years of case management (CM) interventions, three health-service utilization outcomes, and three patient-focused outcomes were examined. The study findings showed that a CBCM had significant effect on reducing patients’ number of hospitalizations and increasing patients’ symptom control and quality of life. The impact of CM on length of stay and emergency department visits was indeterminate. Findings suggest that CBCM can be used as an effective intervention program for Medicare beneficiaries.