Transforming the Workforce to Provide Better Chronic Care: The Role of Local Care Coordinators at CareFirst
Part 6 in the Transforming the Workforce to Provide Better Chronic Care:
The Role of Registered Nurses series.
Click to see the rest of the series.
CareFirst, a commercial insurer serving Maryland, northern Virginia, and the District of Columbia, utilizes local nurse care coordinators to support primary care providers within its patient-centered medical home program. Local care coordinators provide care coordination, care planning, and patient education to chronically ill CareFirst members through a combination of telephonic and in-person encounters.
In addition to highlighting state policy implications, this brief also showcases how Michele Brown, local care coordinator, is able to drive improvements in care for her patients. After three years of operation, CareFirst reported that the total cost of care for patients covered by its PCMH program was $267 million less when compared to projected total cost of care from 2011 to 2013.
This brief is the sixth in a six-part series, supported by the AARP Public Policy Institute, which explores the evolving role of nurses in new delivery system models.
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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. 























































































































































