Medicaid Health Home Impacts And Implications: Chief Operating Officer/VP for Care Management

The Medicaid Health Home — intended to operate under a “whole-person” care philosophy by integrating and coordinating care for people suffering from chronic conditions — requires significant operational adjustment at all levels of the care continuum.

As part of GSI Health’s continuing series examining the impacts and implications of the Medicaid Health Home model, today’s post focuses on the shifting roles, responsibilities and requirements faced by Chief Operating Officers (COOs) and Vice Presidents of Care Management.

The Changing Role Of The COO/VP Care Management Under Medicaid Health Homes

Under the Medicaid Health Homes model, care providers are responsible for ensuring that their clinical programs align with the “whole-person” care philosophy established under The Affordable Care Act of 2010. That means Chief Operating Officers need to modify and adjust their care management, delivery and reporting practices with a clear understanding of the patients and populations they serve.

Key Steps:

  1. Share and reconcile actionable patient information across the care continuum
  2. Use single care planning work-flow based app among virtual care team
  3. Manage referrals with an eye toward “whole-person” care
  4. Maintain patient-focused medication management
  5. Train care managers and primary care physicians to lead virtual care teams
  6. Re-engineer clinical workflow to enable team based care for care coordination and population health programs
  7. Oversee daily operations of Health Home

Care Continuum Realization Technology

While the responsibilities and key steps detailed above provide a solid foundation, they are by no means the only elements required for a Medicaid Health Home’s success. In addition to shifting roles such as the Chief Operating Officer or VP of Care Management, you need a health IT solution capable of providing unprecedented access to information that spans each patient’s entire continuum of care. You need a platform that connects people not systems, one that helps you fill in the information and communication gap with easily accessible and actionable patient care knowledge.

If you missed the previous post in this series, it’s not too late to catch up … Click here to read about how Medicaid Health Homes are changing the role of Chief Medical Officer.

Stay tuned to the GSI Health Blog for the next installment in this series on the impacts and implications of Medicaid Health Homes as we turn our attention to the role of Chief Financial Officer (CFO).

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