Payer Perspective: Care Coordination
Hours: 1.00
The increasing prevalence of patients with chronic illnesses poses major challenges across the U.S. healthcare system to maximize clinical outcomes while minimizing costs. Uncoordinated care results in duplication of services and a lack of necessary services being provided for patients with chronic conditions. Both can lead to higher short-term and long-term costs and poor patient outcomes. Care coordination has been successful in improving clinical outcomes and reimbursement.
The goal of this course is to equip nurses, physicians, and physician assistants with knowledge of the care coordination process and how to apply various components of coordination in the workplace to maximize patient outcomes and reduce costs.
The increasing prevalence of patients with chronic illnesses poses major challenges across the U.S. healthcare system to maximize clinical outcomes while minimizing costs. Uncoordinated care results in duplication of services and a lack of necessary services being provided for patients with chronic conditions. Both can lead to higher short-term and long-term costs and poor patient outcomes. Care coordination has been successful in improving clinical outcomes and reimbursement. The goal of this course is to equip nurses, physicians, and physician assistants with knowledge of the care coordination process and how to apply various components of coordination in the workplace to maximize patient outcomes and reduce costs.
California Board of Registered Nursing
Provider approved by the California Board of Registered Nursing, CEP# 903770
Nurses will receive 1.00 contact hours for participating in this course.
District of Columbia Board of Nursing
District of Columbia Board of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Florida Board of Nursing
Florida Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
American Nurses Credentialing Center
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Nurses will receive 1.00 Nursing Contact Hours after successfully completing this course.
Georgia Board of Nursing
Georgia Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Accreditation Council for Continuing Medical Education
In support of improving patient care, Relias LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Relias LLC designates this enduring activity for a maximum of 1.00 AMA PRA category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
South Carolina Board of Nursing
South Carolina Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Florida Board of Medicine
Florida Board of Medicine (CEBroker Provider #50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
West Virginia Board of Registered Nursing
West Virginia Board of Registered Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
New Mexico Board of Nursing
New Mexico Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Arkansas State Board of Nursing
Arkansas State Board Of Nursing Approved Continuing Education program (CEBroker Provider #50-290).
Nurses will receive 1.00 contact hours for participating in this course.
Ohio State Medical Board
State Medical Board of Ohio (CEBroker Provider #: 50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
Louisiana State Board of Medical Examiners
Louisiana State Board of Medical Examiners (CEBroker Provider #: 50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
Mississippi State Board of Medical Licensure
Mississippi State Board of Medical Licensure (CEBroker Provider #: 50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™.
Kentucky Board of Nursing
Kentucky Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
Mississippi Board of Nursing
Mississippi Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
North Dakota Board of Nursing
North Dakota Board of Nursing (CEBroker Provider #50-290)
Nurses will receive 1.00 contact hours for participating in this course.
New Mexico Medical Board
Physicians will receive 1.00 AMA PRA category 1 Credits™.
South Carolina Board of Medical Examiners
South Carolina Board of Medical Examiners (CEBroker Provider #50-290)
Tennessee Board Of Medical Examiners
Tennessee Board of Medical Examiners (CEBroker Provider #50-290)
Physicians will receive 1.00 AMA PRA category 1 Credits™
Commission for Case Manager Certification
This program has been pre-approved by The Commission for Case Manager Certification to provide 1.0000 hours of continuing education credit to CCM® board certified case managers.
Define care coordination, its components, and process.
Describe the consequences of uncoordinated care.
Describe how care coordination can improve health and reduce healthcare costs.
Outline:
Section 1: Introduction
About This Course
Learning Objectives
Section 2: Care Coordination and Case Management
Meet Rennetta
Care Coordination
Care Coordination Elements
Why is Care Coordination Necessary?
Care Fragmentation
Fragmentation Examples
Impact of Fragmentation
Gaps in Care
Bridging the Gaps
Care Coordination Approaches
Results of Care Coordination
Case Management
Benefits of CM
CM Principles
Case Manager Principles
Goals of CM
What Is The Difference?
The Chronic Care Model
Disease Management
Self-Management
Review
Summary
Section 3: Care Coordination Process and Vendors
Participants
Plan of Care
Evaluation of Care
Cost-Effective Care
Care Coordination Vendors
Private or Public
Medicare
State Medicaid Programs
Department of Veteran Affairs (VA)
Private Sector Efforts
Overcoming Barriers to Care Coordination
Review
Summary
Section 4: Social Determinants of Health
Overview
Impact of SDOH
Economic Stability
Education Access and Quality
Healthcare Access and Quality
Neighborhood and Built Environment
Social and Community Context
Systems-Based Interventions for SDOH
Healthcare Provider-Level Interventions for SDOH
Review
Summary
Section 5: Conclusion
Course Summary
Course Contributor(s)
Resources
References
Cathryn Ayers, RN, MSN has nearly 10 years of critical care experience. She was active in multiple committees to improve patient safety, executed staff education activities, and managed the new graduate orientation program for those entering intensive care units. Cathryn obtained a license for massage and bodywork therapy in 2012 and graduated from the University of North Carolina at Greensboro in 2016 with a Master of Science in Nursing Education. She has provided telephonic case management services and developed program materials to facilitate positive outcomes for people with rare conditions across the United States. Cathryn has a passion for teaching and helping others to be their best. Disclosure: Cathryn Ayers, RN has no Relevant Financial or Non-Financial Relationship with ineligible companies to disclose.
The target audience for this course is: Case Managers; Nurses; Physicians; in the following settings: Acute Care Facility.
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
Relias has a grievance policy in place to facilitate reports of dissatisfaction. Relias will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias.
If you require special accommodations to complete this module, please contact Relias Support by completing the web form (https://www.relias.com/help) or by using the chat functionality.
All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
Reference herein to any specific commercial product, process, or service by trade name, trademark, service mark, manufacturer or otherwise does not constitute or imply any endorsement, recommendation, or favoring of, or affiliation with, Relias, LLC.
All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
If you require special accommodations to complete this module, please contact Relias Customer Support here.
