Payer Perspective: Care Coordination

Course Code: REL-PAY-0-PPCC

Hours: 1

Type: Online Course

Content Expiration Date: 12/31/2025

Learning Objectives:
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

Writer: Cathryn Ayers, RN

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.

Target Audience:
The target audience for this course is: Care and Case Managers; Medical Providers; Nursing Personnel; in the following settings: Hospitals: Acute.

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All courses offered by Relias Learning, 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.

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.

Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.