The complexity of patient care services in hospital inpatient units requires professional inter and intra coordination, inter unit coordination and hospital utility utilization optimally inside the framework of patient center care. Coordination is essential for the patient's treatment to operate effectively, efficiently. Effective patient treatment can prevent swelling of treatment costs. With the INACBGs package payment system, it is almost impossible for a hospital to provide effective and efficient services to avoid rising operating costs, staff costs, inefficient processes, the LOS lengthwise, and unnecessary procedures. This role should be facilitated by the case manager. This research aims to find out the impact of optimizing the case manager on satisfaction and reducing the cost of stroke patients. Methods: the study is used Quasi eksperimen untreated control group design with pretest and posttest, which involves 24 respondents (controls) and 20 respondents (interacts) in inpatient strokes by optimizing the case manager's function. Data is collected using the patient's satisfaction questionnaires and billing sistem. The study was conducted at dr. Soedirman Kebumen Hospital in October - November 2019. Data analysis uses the independent sample t-test to patient satisfaction and mann withney to cost care the patient. Results: From independent samples test on the equal variances assumed known sig value (2-tailed). 023 < 0.05 and mann withtney's test in the Asym section. Sig (2-tailed) equals 0.494 > 0.05. Conclusion: There is a significant impact on the patient's satisfaction, but the cost of the patient care is obtained insignificant effects after optimizing the case manager.