Bringing managed care home to people with chronic, disabling conditions: prospects and challenges for policy, practice, and research.
This article examines the challenges and opportunities inherent in the idea that home care organizations may be able to reinvent themselves into managed care systems for the frail elderly and chronically ill. Data come from three sources: (a) existing literature, (b) a survey with experts, and (c) insights from an organization with direct experience in designing and implementing first- and second-generation managed care programs. The authors conclude that although even the best-positioned home care organizations will face significant challenges in transitioning to managed care systems (e.g., establishing medical linkages, building managed care capacity, securing funding, dealing with regulatory hurdles), changes in the environment may enable these challenges to be overcome. Home care organizations are beginning to use innovative techniques to manage care, and those with a strong commitment to the chronically ill may be interested and capable of pursuing the option of becoming home-based managed chronic care programs.
Kodner
Dennis L
DL
DLK Care Strategies, Atlantic Highlands, NJ and New York University, USA.
Kyriacou
Corinne Kay
CK
D000368:Aged; D002908:Chronic Disease; D003258:Consumer Behavior; D006233:Persons with Disabilities; D006291:Health Policy; D018574:Home Care Agencies / Q000458:organization & administration*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration; D008329:Managed Care Programs / Q000458:organization & administration*; D010346:Patient Care Management; D018802:Patient-Centered Care; D014481:United States