PHMO Care Management 1 PHMO Organizational Structure DUHS - - PowerPoint PPT Presentation
PHMO Care Management 1 PHMO Organizational Structure DUHS Organizational Opportunity Entity PHMO Networks & Populations Northern Piedmont Community Care Medicare & Medicaid Commercial ACO Under/Uninsured Other PHMO Service
1
Opportunity
Northern Piedmont Community Care
Medicare & Commercial ACO Medicaid
Under/Uninsured
DUHS Organizational Entity PHMO Networks & Populations PHMO Service Lines
Other
Ambulatory care management
Dark blue outline = physician network
3
1 2 3
4
5
Definition
monitors, and evaluates the options and services required to meet the client's health and human service needs
and promotion of quality and cost-effective interventions and outcomes
What do care managers (CMs) do?
CMs provide education to patients to promote self managment. They advocate for the patient and link clients with appropriate providers and resources throughout the continuum of health and human services and care settings, while ensuring that the care provided is safe, effective, client-centered, timely, efficient, and equitable.
Goal:
Optimum value and desirable outcomes for all stakeholders
Palliative Care
When appropriate, being able to meet a patient’s needs in the primary care setting through use of specialty rounds may help:
reduction
management
failure / dialysis
management
Endocrinology
Cardiology
For advice on… For advice on…
Geriatrics
For advice on… For advice on…
Nephrology
For advice on…
6
7
number of services, including:
Epic-based providers
MSSP patients to DukeWELL by ambulatory referral
Others
patients to DukeWELL using:
Don’t forget to specify the reason for your referral!