title: Commonwealth Care Alliance. A new approach to coordinated care for the chronically ill and frail elderly that organizationally integrates consumer involvement.
abstract: While medical care is becoming more effective, our health care system is becoming increasingly fragmented from both a care and a financing perspective. This article summarizes our experience with integrating the delivery of care for catastrophically ill and frail elderly. We argue that true integration can only be done within a framework of a financing mechanism that gives all providers the financial incentive to deliver integrated care. Under such a financial arrangement, nurse practitioners and social workers provide much of the care within the home environment. This results in a higher quality care delivery system within a limited budget.
authors.affiliation: 3M Health Information Systems, 3M Health Care, 100 Barnes Road, Wallingford, CT 06492, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Master
authors.forename: Lois
authors.initials: L
authors.lastname: Simon
authors.forename: Norbert
authors.initials: N
authors.lastname: Goldfield
mesh_terms: D000328:Adult; D000368:Aged; D002388:Catastrophic Illness / Q000191:economics* / Q000628:therapy; D002908:Chronic Disease / Q000191:economics* / Q000628:therapy; D003256:Community Participation; D016330:Frail Elderly; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D008404:Massachusetts; D008484:Medicaid / Q000458:organization & administration*; D008875:Middle Aged; D014481:United States