Plan-Funded Team Coordinates Enhanced Primary Care and Support Services to At-Risk Seniors, Reducing Hospitalizations and Emergency Department Visits
Commonwealth Care Alliance developed a health plan that provides low-income, dually eligible, elderly enrollees in Massachusetts with a primary care team made up of a physician, nurse practitioner, and geriatric specialist who work out of the enrollee's primary care clinic.
Health Plan–Financed, Nurse-Led Care Coordination Improves Quality of Care and Reduces Costs for Latinos With Chronic Illnesses and Disabilities
A community-based primary care clinic uses nurses to provide culturally competent care coordination to Latino patients with chronic illnesses and disabilities, leading to greater provision of recommended care, lower health care costs, and enhanced self-management capabilities.
Skilled Nursing Facility Uses Standardized Assessments, Palliative Care Consults, and Root-Cause Analysis to Reduce Readmissions and Improve Staff Morale
A rehabilitation center's recuperative services unit uses a three-part protocol consisting of standardized assessments, palliative care consults and care plans, and root-cause analysis to reduce readmissions and improve staff morale.