RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
RURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. Fral RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESlich, M.B.A. Deborah Curtis. M.P.H.Working Paper # 1035796This study was funded by a grant from the federal Office of Rural Health Policy. Health Resources and Services Administration, DHHS (Grant # CSUR00003-02-0). The conclusions and opinions expressed in the paper are the authors' and no endorsem RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESent by the University of Southern Maine or the funding source IS intended or should be inferred.TABLE OF CONTENTSEXECUTIVE SUMMARY....................RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
.........................iINTRODUCTION..................................................1SECTION ONE: Managed Care and Service Integration for Older PRURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. Fral RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES............5Application to the Long Term Care Sector.................................8The Rural Issues and Questions..........................................11SECTION TWO: Case StudiesPinal and Cochise Counties. Arizona.....................................14The Arizona Long Term Care ServicesProgr RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESam...........................14Pinal County Long Term Care...........................................16Cochise Health Systems (CHS)...................RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
.......................22The Carle Clinic........................................................27SECTION THREE: Lessons Learned and PolicyImplicatioRURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. Fral RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES.....................39CONCLUSIONSAND POLICY IMPLICATIONS........................................56ENDNOTESREFERENCESAPPENDIXEXECUTIVE SUMMARYDriven by growing demand and the need to control expenditures, states and the federal government are searching for new managed care strategies, such as capita RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESted financing and coordinated case management, that integrate the financing and delivery of primary care, acute and long-term care services. For ruralRURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
communities, the development of organizational and delivery systems which better integrate and manage primary, acute and long term care services may RURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. Fral RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESfer insights into the opportunities and challenges of managing and integrating primary, acute, and long term care in rural settings. These examples include: (1) Cochise and Pinal Counties, Arizona, county-based managed care programs which, operating under the state s managed Medicaid long term care RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESprogram (Arizona Long Term Care Services), manage a capitated primary, acute and long term care service network serving frail elderly and physically dRURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
isabled Medicaid clients: and (2) The Cade Clinic, one of four (and the only rural) sites for the HCFA-sponsored Community Nursing Organization (CNO) RURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. Fral RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESfaced in developing models that accommodate the realities and circumstances of rural communities and health systems. The case studies examine the importance of population size, the effects of service supply and infrastructure, the role of state and federal policies, and prior experience with managed RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES care in the development and success of these initiatives. These demonstrations suggest that small population bases do not preclude the development ofRURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
managed care programs for these populations and that various forms of risk-based financing can be used to protect providers and consumers. The introdRURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. Fral RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESse counties. Not surprisingly, the level of managed care penetration in the broader health care market and the level of provider and consumer experience with managed care are critical factors in facilitating or inhibiting the development of managed care programs for the elderly and disabled. The cha RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESracteristics of the community, county, or region, including the effectiveness of local leaders, the sense of community and the degree of support for lRURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
ocal organizations and providers, can all be critical factors in the development of these initiatives. Differences in professional cultures and mistruRURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. Fral RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESthe delivery of services across these two sectors.Although experience with managed care models that integrate the financing and delivery of primary, acute and long term care services is limited, especially in rural areas, this is likely to change as states expand their use of Medicare and Medicaid. RURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICESSection 1115 waiver demonstrations. Whether these programs work, how much they cost, and whether they deliver high quality care are questions of paramRURAL MODELS FOR INTEGRATING AND MANAGING ACUTE AND LONG-TERM CARE SERVICES
ount policy importance. As these initiatives are updated and evaluated, it is critical that states and the federal government carefully consider the sRURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. FralRURAL MODELS FOR INTEGRATING AND MANAGINGACUTE AND LONG-TERM CARE SERVICESAndrew F. Coburn. Ph.DElise J. Bolda, Ph.DJohn w. Seavey, Ph.D Julie T. FralGọi ngay
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