| Case in Point | CMRG | Patient Advocacy | OR Manager | DecisionBriefs | Friday, May 24, 2013 |
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Using Care Coordination to Cut Costs
How Coordinated Care Delivers Outcomes in the Medical Home
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If you ask someone on the street about care coordination, you’re likely to get a blank stare. That’s because when care coordination works, it’s invisible. But it becomes painfully apparent when it fails. Consider these top trends:
- Patients and families are frustrated by fragmented “silos” in healthcare.
- Poor hand-offs lead to delays and miscommunications in care that may be dangerous to health.
- There is enormous waste associated with unnecessary referrals, duplicate testing, unwanted and unnecessary specialist-to-specialist referral.
- Uncoordinated care represents 30% of all medical costs, 45% of all drug costs and 32% of total plan costs.
Who is responsible to ensure care is coordinated? Some say the physician. Some say the nurse. Others say it is the case manager. In reality, to have effective coordination care, all members of the healthcare team, including the patient and the family, must have a role in the process.
Join us on May 15, 2012 at 2 p.m. (ET) for a discussion with three leaders who will discuss care coordination and preventive strategies in the Patient Centered Health Care Home. Bring your questions and your ideas to share so that together we can better understand the concept of care coordination and the impact it can have on the healthcare system.
About the Webinar
The patient centered health care home serves as a model to ensure care is coordinated by transforming how primary care is organized and delivered. The medical home provides the platform that allows the primary care physician to work collaboratively with a team of professionals to ensure care is coordinated, streamlined and meets the individual needs of the patient. To accomplish this, the medical home must be able to provide care that is:
- Patient-centered: The primary care medical home provides primary health care that is relationship-based with an orientation toward the whole person. Partnering with patients and their families requires understanding and respecting each patient’s unique needs, culture, values and preferences.
- Educational: Actively supports patients in learning to manage and organize their own care at the level the patient chooses. Recognizing that patients and families are core members of the care team, medical home practices ensure that they are fully informed partners in establishing care plans.
- Comprehensive: The primary care medical home is accountable for meeting the large majority of each patient’s physical and mental health care needs, including prevention and wellness, acute care, and chronic care. Providing comprehensive care requires a team of care providers. This team might include physicians, advanced practice nurses, physician assistants, nurses, pharmacists, nutritionists, social workers, medical assistants, case managers and other professionals who play a part in linking patients to providers and services in their communities.
- Coordinated: The primary care medical home coordinates care across all elements of the broader health care system, including specialty care, hospitals, home health care, and community services and supports. Such coordination is particularly critical during transitions between sites of care, such as when patients are being discharged from the hospital. Medical home practices also excel at building clear and open communication among patients and families, the medical home, and members of the broader care team.
- Systems-based approach to quality and safety: The primary care medical home demonstrates a commitment to quality and quality improvement by ongoing engagement in activities such as using evidence-based medicine and clinical decision-support tools to guide shared decision making with patients and families, engaging in performance measurement and improvement, measuring and responding to patient experiences and patient satisfaction, and practicing population health management to improve preventative strategies to improve wellness.
Care coordination is an essential function of the case management process, so it is logical that case managers will have a critical role in the new models such as the patient centered health care home. To be effective, it will be important that case managers understand the goals and work to ensure they are up to date clinically and professionally and be able to demonstrate the value they bring to the practice.
Program Objectives
- Describe the outcomes that can be achieved through effective care coordination.
- Discuss the role of the case manager in the patient centered health care home.
- Explain the role technology plays in improving care coordination, addressing preventive strategies and improving communication across all providers throughout the medical neighborhood.
Our Webinar Will Answer These Questions
- What is care coordination?
- Why is the medical home a good model for care coordination?
- Who is responsible for care coordination?
- What tools are available to ensure care is coordinated in the medical home?
- What is the role of the patient and family in the medical home model?
- What competencies do case manager need to have to be effective as a member of the healthcare team?
- What outcomes will payers, providers and consumers gain from a coordinated health care system?
- What preventive strategies can be put into place to improve the health and contain escalating health care costs as part of the care coordination process?
Faculty
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Patrice V. Sminkey comes to the Commission from URAC, where she most recently served as senior director of sales. Prior to that, she was senior vice president, operations and client management, Patient Infosystems in Rochester, N.Y. She brings a proven track record in operations management in small and large operations, multilevel services and cross-functional teams. With over 20 years’ experience in health care related roles, she has extensive experience in client management and coordination, including marked improvement in client retention, timely and fiscally sound program implementation and an expanding book of business. As chief executive officer, Sminkey oversees the management of all activities related to the Commission, including the leadership of the Commission’s strategic vision, business development and all its’ programs, products and services; ensuring the provision of quality services to and by the Commission. She is a direct liaison to the Commission’s Executive Committee and works closely with its full board of commissioners. She works with CCMC’s volunteer leadership to evaluate and develop potential new products for implementation by the CCMC, and she establishes and maintains communication and working relationships with other organizations, agencies, groups, corporations and individuals. |
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Connie Phillips-Jones has been with Medecision since 2008. She joined Medecision after more than 25 years’ experience developing and managing case management, care coordination, collaborative care programs. She works directly with Medecision customers for implementing programs supported by Medecision technology solutions.
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Ms. Beitel is a 1981 graduate of Community College of Allegheny County with an Associate Degree in Nursing and a 2010 graduate of DeVry University with a Bachelor of Science in Technical Management. After several years as a clinician with a focus on geriatrics, Ms. Beitel joined Keystone Health Plan West, Inc., in 1989 a subsidiary of Blue Cross of Western Pennsylvania and now Highmark, in the Utilization Review and Case Management area. In 1998 Ms. Beitel became the clinical manager for the SeniorCareBLUE long term care case management joint venture between Highmark and Presbyterian SeniorCare. Currently Ms. Beitel is the Manager of Highmark’s Patient Centered Medical Home (PCMH) Care Coordination team. Her staff consists of 10 PCMH Nurse Care Coordinators who are either embedded or work virtually with the 12 pilot practices. Ms. Beitel’s team assists the practices with identifying their high risk patients and those with care gaps, along with integrating overall medical home care coordination strategies. |
Moderator: |
Patrice V. Sminkey, RN, Chief Executive Officer, Commission for Case Manager Certification
Connie Phillips-Jones RN, MSN, CCM, Principal Clinical Consultant, Medecision
Amy Beitel, RN, BSTM, CCM
Who Should Attend
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Purchase Options
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- $329 per location, unlimited viewing per location (a special rate is available for solo practitioners and the military. Please call 301-354-1769 for promo code for a price reduction if you qualify.
- Live Webinar Registration – $329 (per-site fee)
- Webinar Recording on CD-ROM – $329
- Live Webinar and CD-ROM – $379
About URAC
URAC has developed its Patient Centered Health Care Home (PCHCH) programs to educate and guide health care practices, and their sponsoring health plans, insurers and pilot programs through transformation into truly patient-centered health care homes. Learn more »
Questions?
For questions regarding the Webinar or to register by phone, contact Hope Kabik at 301-354-1769.
For content questions regarding this Webinar, contact Anne Llewellyn at 954-254-2950 or email allewellyn@dorlandhealth.com.
*Dorland Health does not offer any refunds for the webinar. All sales are final.
For technical support questions, you can contact the Webex technical support line at 1.866.229.3239.
How Does the Webinar Work?
The live audio is delivered to your location over the telephone or your computer speakers. The Power-Point presentations are presented over the Internet and are available to print out before the program. This is like a talk-radio program with visuals on the Web. You and your team will be able to have a live Q&A with all the speakers.
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