Care Continuum Alliance Research Leaders Contribute to PCPCC Care Coordination Paper

WASHINGTON, D.C.—A new publication from the Patient-Centered Primary Care Collaborative (PCPCC) on care coordination research and practice includes a paper by a Care Continuum Alliance member leader on elements of population health management that support coordinated care.

The PCPCC released "Core value, community connections: Care coordination in the medical home" today at its 5th Annual Summit. Sponsored by the PCPCC Care Coordination Task Force, the publication explores care coordination, an essential and evolving component of the patient-centered medical home (PCMH), and offers insights by thought leaders, case studies from clinicians in the trenches and results of a provider survey on the subject.

Jaan Sidorov, MD, MHSA, FACP, principal, Sidorov Health Solutions, and long-time member leader for the Care Continuum Alliance, authored a paper on key population health management tools to support the PCMH, including health risk assessments, risk stratification, patient engagement, care management, telemonitoring, data analysis and outcomes measurement.

"PCMHs will need to be able to proactively identify patients at special risk, recruit and enter them into care coordination programs that emphasize shared decision-making and self-care," Dr. Sidorov wrote. "Data management and analytics will likewise be critically important to shape local care programming and document the follow-on successes. Fortunately, the components that comprise [population health management] are readily available to accomplish these goals."

Also contributing to the publication's development, as a member of the PCPCC Care Coordination Task Force, was Care Continuum Alliance Research Director Karen Moseley. The Care Continuum Alliance, a population health management trade association with more than 200 corporate and individual members, sits on the PCPCC Executive Committee. The publication released today was developed with financial support from Phytel and Merck and is available as a free download at:

www.pcpcc.net/guide/coordination_guide

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About the Care Continuum Alliance
The Care Continuum Alliance represents more than 200 organizations and individuals and aligns all stakeholders along the continuum of care toward improving the health of populations. Through advocacy, research and education, The Care Continuum Alliance advances population-based strategies to improve care quality and value and to reduce preventable costs and improve quality of life for individuals with and at risk of chronic conditions. Learn more at http://www.carecontinuum.org.