| Geisinger
Health Plan: Smoother Sailing For Patient Healthcare Navigation
A hands-on guidance in new models of care that
helps
patients navigate the healthcare system and better manage their own
chronic health conditions is now available.
Janet Tomcavage, RN, vice president of health
services
for Geisinger Health Plan in Danville, Penn., presented such a model
care coordination program at Taconic IPA’s Spring
Collaborative.
Her discussion focused on the patient-centered
medical home.
"Helping patients better manage their own chronic
health
conditions, and taking a team approach to smooth transitions and work
with specialists and hospitals as an extended team, are essential
elements of the patient-centered medical home practice," said Dr. A.
John Blair III, president of Taconic IPA.
Tomcavage is responsible for development and
implementation of innovative medical management strategies for
Geisinger, including medical home, disease management and case
management approaches.
The event was to be hosted by TransforMED and
Masspro.
Both companies work with primary care physician practices in the Hudson
Valley to adopt more efficient, effective care delivery models. Both
have worked with practices in the Hudson Valley Medical Home Project
and as a result 11 medical practices at 51 sites received Level 3
medical home recognition from the National Committee for Quality
Assurance. (NCQA).
"As the leaders of care teams within their own
practices, physicians are in a critical position to decide how care
coordination is leveraged to improve health outcomes and lower health
care costs," said Dr. Terry McGeeney, president and CEO of TransforMED.
The use of "embedded case managers" in primary
care
practices is at the heart of the patient-centered medical home model
that Geisinger Health Plan launched in 2006.
Geisinger engages 61 nurse case managers who work
as
part of the healthcare team at 37 physician offices. These case
managers identify patients with multiple chronic health conditions, see
patients, work with physicians to develop and manage each
patient’s care plan and coordinate care each patient receives
from specialists or while staying in the hospital. The program has
yielded a 15 percent to 20 percent decrease in hospital readmissions at
every measurement phase of the program.
Tomcavage cites the case manager as "an important
factor" in Geisinger’s success.
"The embedded case manager is a part of the
primary care
team and can walk down the hallway and talk to each member of the
health care team," she said, resulting in a bond between the case
manager, the patient and the primary care physician "that becomes the
foundation supporting the patient-centered medical home model."
Addresses: The Taconic IPA, 380 Maple Ave. #206,
Vienna, VA 22180; (703) 319-0957, www.taconicipa.com.
Geisinger, 100 N Academy Ave., Danville, PA 17822; (570) 271-6211, www.Geisinger.org.
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