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Care Management Plus

Developed by Intermountain Health Care in Salt Lake City, Utah Primary care physicians refer patients to a care manager (either a nurse of social worker) instead of a specialist Care managers assess the patient's needs, help to create a care plan, & help implement that plan - may involve - patient education - medication management - linking to community resources - tracking follow-up with other providers - patient follow-up - evaluating health outcomes Notes: - associated with 20% reduction in mortality & 24% reduction in hospitalizations in older adults with diabetes mellitus - 8-12% improvement in productivity for physicians who sent their patients to a care manager

General

Collaborative care model

References

  1. Geriatric Review Syllabus, 7th edition Parada JT et al (eds) American Geriatrics Society, 2010