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Integrated care, also known as integrated health, coordinated care, comprehensive care, seamless care, interprofessional care or transmural care, is a worldwide trend in health care reforms and new organizational arrangements focusing on more coordinated and integrated forms of care provision.
A coordinated care organization (CCO) is a community based, integrated care organization created by the state of Oregon to allow for local and regional distribution and coordination of healthcare to segments of the state's population covered under the Oregon Health Plan.
Case managers working for health care providers typically do the following: Verify coverage & benefits with the health insurers to ensure the provider is appropriately paid; Coordinate the services associated with discharge or return home; Provide patient education; Provide post-care follow-up; and; Coordinate services with other health care ...
An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitioners. They use alternative payment models, normally, capitation. The organization is accountable to ...
Care coordination is an essential component of the PCMH. Care coordination requires additional resources such as health information technology and appropriately-trained staff to provide coordinated care through team-based models. Additionally, payment models that compensate PCMHs for their functions devoted to care coordination activities and ...
One often expressed suggestion for controlling public health care costs is for Medicare to adopt a strategy of the private insurance industry by assigning a care coordinator to the patient. This ...
A clinical pathway is a multidisciplinary management tool based on evidence-based practice for a specific group of patients with a predictable clinical course, in which the different tasks (interventions) by the professionals involved in the patient care are defined, optimized and sequenced either by hour (ED), day (acute care) or visit (homecare).
Managed care plans and strategies proliferated and quickly became nearly ubiquitous in the U.S. However, this rapid growth led to a consumer backlash. Because many managed care health plans are provided by for-profit companies, their cost-control efforts are driven by the need to generate profits and not providing health care. [5]