Holistic Care Across the Continuum

Healthcare is complex, expensive, and fragmented. From the payment structure to hospital operations and everything in between, healthcare rules, procedures, and processes create barriers for clients. What can we do to reduce the fragmentation and focus on not just physical health but also mental health and social determinants of health?

Part of the solution is integrated, multidisciplinary care management across the continuum. Care and/or case management occurs in multiple settings (hospitals, the community, insurance, etc.,) and with collaborative partners to achieve business goals. While care management staff are hired at each of these settings, their collaboration across the healthcare continuum is not always collaborative to improve outcomes for the client population. Disparate clinical documentation systems hinder the effective management of clients.

Collaborating on care management principles across the continuum and managing complex clients holistically will result in improved outcomes. Starting with analytics, focusing on clinical assessments, and integrating community resources will lead to reducing fragmentation and improving the quality of care.

The presenter will share best practices regarding effective care management programs across the continuum of care, and provide a checklist of actionable items to implement care management solutions programmatically.