Increasingly, health plans will need to develop robust care coordination programs and broaden their networks to include comprehensive service providers, according to a perspective written by Bruce Chernof, MD, president and CEO of The SCAN Foundation, an independent public charity that works to transform healthcare for older adults.
"Health plans are still learning the types of services they may want to contract for as well as developing perspectives on network adequacy, quality oversight and data sharing," wrote Dr. Chernof. "What is clear is that community-focused care coordination, particularly at times of transition like hospital to home, is the lynchpin to better care at lower costs."
The challenge, Dr. Chernof argues, is extending current network models to include community-based providers that can deliver robust care coordination and manage specific community-oriented services.
As Medicare-Medicaid integration pilots, managed care models and accountable care organizations grow in response to industry changes, community-based organizations can work with health systems participating in these new care models to develop new revenue streams that contribute positively to their organization's fiscal health, according to Dr. Chernof.
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