7 Metrics to Build a Business Case for a Multidisciplinary Care Coordination Team

Shameka ColesBecause care management and coordination often defy traditional return on investment formulas, come budget time, AltaMed Health Services Corporation had to take a hard look at contributions of its multidisciplinary care team to the organizational bottom line.

Shameka Coles, AltaMed’s associate vice president of medical management, outlines seven key metrics presented to AltaMed’s CFO tying the coordinated care team to Altamed’s financial goals—data that ultimately secured funding for phase four of the coordinated care management initiative.

During a May 2015 webinar, A Comprehensive Care Management Model: Care Coordination for Complex Patients, now available for replay, Ms. Coles shared the key steps in development, rollout and evaluation of this care management model for AltaMed’s highest risk patients, a population that includes dual eligibles.

Length: 3:48 minutes

HCSC’s Community Behavioral Health Links Essential to Duals Care Coordination

Relationships with community organizations that support mental health as well as recovery from addiction are essential to care coordination of Medicare-Medicaid beneficiaries, notes Julie Faulhaber, vice president of enterprise Medicaid at Health Care Service Corporation (HCSC). These collaborations enable HCSC to address the needs of duals as “a whole sick person, and not just as a diagnosis,” she explains, noting that duals often suffer from depression along with some physical disability. HCSC also has its own integrated team with behavioral health expertise.

Julie Faulhaber shared her organization’s approach to designing a care coordination model for dual eligibles and initial findings from these new programs during a March 12, 2014 webinar Moving Beyond the Medical Care Coordination Model for Dual Eligibles, a 45-minute program sponsored by The Healthcare Intelligence Network.

Length: 4:06 minutes

Dual Eligibles: Closing Care Gaps and Engaging Members in Self-Management

The philosophy that healthcare is local — and therefore, care needs to be local and community-based — forms the core of WellCare’s efforts to connect its dually eligible population to health services, explains Pamme Taylor, WellCare’s vice president of advocacy and community-based programs. The Tampa-based healthcare company takes a culturally competent approach to assessing duals’ unique personal circumstances, ensuring their “soft landing” into WellCare’s care coordination system.

Care managers at the heart of WellCare’s multidisciplinary team, conducting a comprehensive needs assessment with each Medicare-Medicaid beneficiary and driving the resulting care plan, ensuring duals’ complex care needs are met at the most appropriate time and level.

Ms. Taylor shared Wellcare’s strategies for meeting members’ needs with community-based partnerships and engaging duals in self-management of their care during an October 2, 2013 webinar, Dual Eligibles: Closing Care Gaps and Engaging Members in Self-Management.

Length: 7:16 minutes

Care Coordination for Dual Eligibles: A Results-Oriented Approach

SCAN Health Plan’s Interdisciplinary Care Team for dual eligibles is a diverse multiprofessional group encompassing many geriatric specialists, explains Dr. Timothy Schwab, chief medical officer of SCAN Health Plan. Dr. Schwab describes some of the challenges of risk stratification in a dual eligible population, and details case management support for the percentage of dual eligibles that require support for disabilities.

Dr. Schwab shared his organization’s strategic approach to serving the dual eligible market during a December 6, 2012 webinar, Care Coordination for Dual Eligibles: A Results-Oriented Approach, a 45-minute webinar sponsored by The Healthcare Intelligence Network.

Length: 9:09 minutes