Section 1: Introduction A. About This Course B. Learning Objectives Section 2: The Complexity of Care Coordination A. Meet Laura B. Define Care Coordination C. The Components of Care Coordination D. Why is Care Coordination Necessary for Those with Chronic Diseases? E. The Chronic Care Model F. Self-Management G. Case Management H. Different Care Coordination Approaches I. Results of Care Coordination J. Review K. Summary Section 3: Creating a Better Experience with Care Coordination A. Identify Beneficiaries B. Identify Participants C. Developing and Implementing the Plan of Care D. Evaluation of Care E. Cost Effectiveness F. Review G. Summary Section 4: Current Efforts A. Care Coordination Vendors B. Private or Public C. Medicare D. State Medicaid Programs E. Department of Veteran Affairs F. Private Sector Efforts G. Review H. Summary Section 5: Social Determinants of Health A. What is Working and What is Not B. Measuring Outcomes C. Review D. Summary Section 6: Conclusion A. Summary B. Course Contributors C. Resources D. References E. Congratulations! F. Exam
Jessica has almost 15 years of experience in nursing and 10 years in MDS/PAC working with organizations for the purposes of assessment, reimbursement, training, organizational, and leadership development. In these roles, she has acted as a consultant and auditor. Jessica has written content for diverse healthcare topics, including health and human services, compliance and more. Disclosure: Jessica Cairns, RN, RAC-CT, CMAC has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.Expert Reviewer: Dr. Janet Albers, MD
Janet Albers MD graduated from Southern Illinois University School of Medicine in Springfield, IL before completing a residency in Family Medicine at the Mayo Graduate School of Medicine in Rochester, Minnesota. She spent several years as faculty at Mayo- Rochester prior to transferring to Mayo Scottsdale to begin a new residency program there. She returned home to Springfield as Faculty within the Family Medicine residency at SIU in 1997 where she served as program director. In 2014, she was promoted to the role of Chair of the Department of Family and Community Medicine. Dr. Albers leads the FCM Department in innovative approaches to interprofessional team-based patient care, population health, and education of tomorrow’s workforce. Disclosure: Dr. Janet Albers, MD has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.Staff Writer: Rebecca Smallwood, MBA, RN
Rebecca Smallwood, MBA, RN, has extensive experience across a wide spectrum of healthcare settings including: rural and urban acute care hospitals, public health, ambulatory surgery, higher education, and commercial healthcare learning organizations. Her roles have included: medical/surgical, ED, and OR staff and charge nurse; Director of School Health Services/school nurse; Public Health Epidemiology and Bioterrorism Preparedness Specialist; Infection control practitioner; Quality Management Specialist; Organizational Development Specialist; and Educator. Prior to joining Relias as a SME writer, she provided healthcare learning and development consultation to Swank Healthcare and was the Director of Education Services for Health.edu, a division of Texas Tech University Health Sciences Center. Rebecca earned a diploma in nursing from Methodist Hospital School of Nursing in Lubbock, Texas and an MBA from Wayland Baptist University. Disclosure: Rebecca Smallwood, MBA, RN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.