title: Partnering managed care and community-based services for frail elders: the care advocate program.
abstract: OBJECTIVE
  To describe a demonstration program that uses master's-level care managers (care advocates) to link Medicare managed care enrollees to home- and community-based services, testing whether referrals to noninsured services can reduce service usage and increase member satisfaction and retention.
  
  
  METHODS
  Using an algorithm designed to target frail, high-cost users of Medicare insured healthcare services, the program partners PacifiCare's Secure Horizons and four of its medical groups with two social service organizations.
  
  
  METHODS
  Three care advocates located in two community-based social services agencies using telephone interviews to interact with targeted elders living in the community.
  
  
  METHODS
  Three hundred ninety PacifiCare members aged 69 to 96 receiving care from four PacifiCare-contracted medical groups.
  
  
  METHODS
  The 12-month intervention provides telephone assessment, links to eight types of home- and community-based services, and monthly follow-up contacts.
  
  
  METHODS
  Sociodemographic characteristics of intervention participants, types of service referrals, and acceptance rates.
  
  
  RESULTS
  Lessons learned included the importance of building a shared vision among partners, building on existing relationships between members and providers, and building trust without face-to-face interactions.
  
  
  CONCLUSIONS
  The program builds on current insured case management services and offers a practical bridge to community-based services.
authors.affiliation: Andrus Gerontology Center, University of Southern California, Los Angeles, California 90028, USA. Wilber@usc.edu
authors.forename: Kathleen H
authors.initials: KH
authors.lastname: Wilber
authors.forename: Douglas
authors.initials: D
authors.lastname: Allen
authors.forename: George R
authors.initials: GR
authors.lastname: Shannon
authors.forename: Sam
authors.initials: S
authors.lastname: Alongi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D002140:California; D003153:Community Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D016330:Frail Elderly; D006297:Health Services Accessibility / Q000458:organization & administration*; D006302:Health Services Research; D006699:Home Care Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration*; D006278:Medicare / Q000458:organization & administration; D010344:Patient Advocacy; D017060:Patient Satisfaction; D010865:Pilot Projects; D015397:Program Evaluation; D012017:Referral and Consultation; D012947:Social Work