Payer Perspective: Care Coordination of Chronic Diseases for Clinicians


Care coordination is the deliberate organization of patient care activities between two or more participants involved in a patient’s care to facilitate the appropriate delivery of healthcare services. Increasing prevalence of chronic illness among Americans, even as life expectancy grows and the population ages, poses major challenges to the medical profession and the entire healthcare system. Coordination is a multifaceted activity that requires effective participation among different professionals, service organizations, and most importantly the patient. Uncoordinated care can result in duplication of service or lack of necessary services for patients with chronic conditions. Both examples can lead to higher short-term and long-term costs and worse patient outcomes. Conversely, coordination of care can impact provider reimbursement. This course will provide information on the process of care coordination, what is practiced today, and what we can do in the future. We will also review the different components to care coordination and how to apply these components in your workplace.


Hours: 1.25


Certificates provided by accrediting body (13 Match)

Association of Social Work Boards

1.25 HOURS

Relias, LLC, #1273, is approved as a provider for social work continuing education by the Association of Social Work Boards (ASWB), through the Approved Continuing Education (ACE) program. Relias, LLC maintains responsibility for the program. ASWB Approval Period: 2/10/2018-2/10/2021. Social workers should contact their regulatory board to determine course approval for continuing education credits.

Course Delivery Format: Asynchronous Distance Learning-interaction includes quizzes with questions and answers, posttests. This module is Reading-Based.

Social workers participating in this course will receive 1.25 Clinical continuing education clock hours.

New York State Education Department, Office of the Professions, Division of Professional Licensing Services, Social Work Unit

1.25 HOURS

Relias, LLC is recognized by the New York State Education Department's State Board for Social Work as an approved provider of continuing education for licensed social workers #SW-0009.

Materials that are included in this course may include interventions and modalities that are beyond the authorized practice of licensed master social work and licensed clinical social work in New York. As a licensed professional, you are responsible for reviewing the scope of practice, including activities that are defined in law as beyond the boundaries of practice for an LMSW and LCSW. A licensee who practices beyond the authorized scope of practice could be charged with unprofessional conduct under the Education Law and Regents Rules.

As a provider of online, asynchronous education, some courses offered by Relias Learning are considered “self-study” under section 74.10(c)(2)(ii)(b)(4) of the Commissioner’s Regulations. The regulations limit self-study activities taken from a provider approved by the Education Department to no more than 12 hours in the 36-month registration period or one-third of the hours in a registration period other than 36 months.

Social workers will receive 1.25 continuing education hours for participating in this course. This activity is approved for 1.25 contact hours.

California Board of Registered Nursing

1.25 HOURS

Provider approved by the California Board of Registered Nursing, CEP# 13791

Nurses will receive 1.25 contact hours for participating in this course.

District of Columbia Board of Nursing


DC-RN -- District of Columbia Board of Nursing Approved Continuing Education program (CE Provider #50-290).

Nurses will receive 1.20 contact hours for participating in this course.

Florida Board of Nursing


Florida Board of Nursing CE Provider #: 50-290

Nurses will receive 1.00 contact hours for participating in this course.

American Nurses Credentialing Center

1.25 HOURS

Relias, LLC is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Nurses will receive 1.25 contact hours for participating in this course.

Georgia Board of Nursing

1.25 HOURS

Georgia Board of Nursing CE Provider #: 50-290

Nurses will receive 1.25 contact hours for participating in this course.

Accreditation Council for Continuing Medical Education

1.25 HOURS

Relias LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Relias LLC designates this enduring material activity for a maximum of 1.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

South Carolina Board of Nursing

1.25 HOURS

This program was approved by the South Carolina Board of Nursing Approved Continuing Education Program (CE provider #50-290) CE Broker Course # 20-[Custom_Code]

Florida Board of Medicine

1.25 HOURS

Florida Board of Medicine CE Provider #: 50-290

Florida Physician Assistants

1.25 HOURS

West Virginia Board of Registered Nursing

1.25 HOURS

Commission for Case Manager Certification

1.25 HOURS

This activity is approved for 1.25 contact hours.

Course Details

Course Code: REL-PI-0-P85
Hours: 1.25
Type: Online Course
Content Expiration Date: 11/30/2020
Learning Objectives:
Define and describe the role care coordination can play in managing health and healthcare costs.
Describe what successful care coordination looks like and who is involved.
Describe how uncoordinated care can lead to waste and duplication of services.
Explain how to best follow-up with both providers and members so comprehensive clinical data is shared.
Identify the components and efforts involved in care coordination.
Apply new knowledge of techniques to improve care coordination in your current practice.

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

Staff Writer: Jessica Cairns, RN, RAC-CT, CMAC
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 over 25 years of experience across a spectrum of healthcare settings including: rural and urban acute care hospitals, public health, ambulatory surgery center, higher education, and commercial organizations. Her roles have included: medical/surgical, ED, and OR staff nurse and charge nurse positions; director of health services / school nurse for PK-12th grades; public health epidemiology and bioterrorism preparedness professional; Infection control practitioner; quality management specialist; organizational development specialist; and educator. Prior to joining Relias Learning as a SME and Content Writer, she provided clinical and healthcare learning and development consultation to Swank Healthcare and was the Director of Education Services for, a division of Texas Tech University Health Sciences Center. She has authored over 100 live and web-based educational presentations and articles on clinical, patient safety, regulatory, leadership, patient experience, and performance improvement topics. Rebecca earned a diploma in nursing from Methodist Hospital School of Nursing in Lubbock, Texas in 1989 and an MBA in Healthcare Administration from Wayland Baptist University in 2010. Disclosure: Rebecca Smallwood, MBA, RN has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Target Audience:
The target audience for this course is: Physician Assistants; Nurses; Physicians; in the following settings: All Healthcare Settings.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
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 ( 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.