Care Coordination
FEATURED ARTICLE
A Day in the Life of Nurse Planner Joan Kindt in the Minnesota Health Care Home Program
/in Policy Minnesota Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health Coverage and Access, Long-Term Care, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Workforce Capacity /by NASHP StaffHealth care reform goals established by the Minnesota Legislature call for all Minnesotans to have access to patient-centered care, accessible, comprehensive, and coordinated primary care. The HCH program is the path to these goals. Becoming a health care home (HCH) in Minnesota means adopting “an approach to primary care in which primary care providers, families, […]
Transforming the Workforce to Provide Better Care: The Role of Nurses in Certifying Minnesota Health Care Homes
/in Policy Minnesota Reports Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Quality and Measurement, Workforce Capacity /by Mary TakachPart 4 in the Transforming the Workforce to Provide Better Chronic Care: The Role of Registered Nurses series. Click to see the rest of the series. Minnesota Health Care Homes (HCH), a patient-centered medical home initiative, utilizes regionally-based nurse planners to ensure that HCH practices are meeting specific standards of care that aim to foster […]
A Day in the Life of Behavioral Health Nurse Care Coordinator Amber Morgan of Hennepin Health
/in Policy Minnesota Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Long-Term Care, Physical and Behavioral Health Integration, Primary Care/Patient-Centered/Health Home, Workforce Capacity /by NASHP StaffCaring for the health care needs of vulnerable populations has inherent challenges. Doing this in an accountable care organization (ACO), where providers bear financial risk for meeting cost, quality, and patient satisfaction metrics, intensifies the challenges. When Hennepin Health launched in 2012 to serve as a safety-net ACO for Minnesota’s early Medicaid expansion population, it […]
Transforming the Workforce to Provide Better Chronic Care: The Role of a Behavioral Health Nurse Care Coordinator in Minnesota
/in Policy Minnesota Reports Behavioral/Mental Health and SUD, Care Coordination, Chronic and Complex Populations, Chronic Disease Prevention and Management, Community Health Workers, Cost, Payment, and Delivery Reform, Health Coverage and Access, Health System Costs, Physical and Behavioral Health Integration, Population Health, Primary Care/Patient-Centered/Health Home, Workforce Capacity /by Mary TakachPart 3 in the Transforming the Workforce to Provide Better Chronic Care: The Role of Registered Nurses series. Click to see the rest of the series. Hennepin Health, a safety-net accountable care organization in Minnesota, has begun to integrate primary care into Hennepin County Mental Health Center through a behavioral health nurse care coordinator. The […]
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
States Use Appendix K and Emergency Waivers to Support Home- and Community-Based Services in Response to COVID-19
/in COVID-19 State Action Center Charts, Featured News Home, Maps Care Coordination, Children/Youth with Special Health Care Needs, Chronic and Complex Populations, Chronic Disease Prevention and Management, COVID-19, Health Equity, Long-Term Care, Medicaid Managed Care, Physical and Behavioral Health Integration, Population Health, Social Determinants of Health /by Salom Teshale