Managing Complex Care: Improve Effectiveness through Clinical Integration, Population Health Best Practices

Posted by Continuum on Feb 9, 2016 11:00:00 AM

Many primary care physicians (PCPs) struggle to provide high-quality care for patients with complex needs. 

A recent international survey* confirms this challenge: Nearly 25 percent of U.S. PCPs say they are not well-prepared to care for people with multiple chronic illnesses. 

Hurdles include lack of care coordination and gaps in access, according to the Commonwealth Fund study. Its authors call for strengthening the nation’s primary care infrastructure, in part by improving communication among providers and increasing access to care.

Two overarching approaches can help doctors achieve these goals, while also reducing the disproportionate costs of complex care: participation in a clinically integrated network (CIN), and use of population health best practices.

To learn more about the Five Pop Health Critical Elements, download our checklist now.  

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Topics: Triple Aim, care continuum, Healthcare, gaps in care, population health tools, CIN

Local Care Director - Key to Successful Coordinated Care

Posted by Continuum on Nov 5, 2014 9:45:00 AM

Collaborating with the care team to engage patients

Care coordination is essential to improving utilization management. The Patient Care Team often consists of a nurse Patient Care Coordinator (PCC), a primary care physician and someone within the provider’s office who serves as the PCC’s right hand. This person collaborates with the PCC and helps to engage patients and improve patient care delivery. Introducing the Local Care Director (LCD).

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Topics: Coordinated Care, care continuum, health access, local care director

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