1. Why is CCA targeting a population that most insurers tried to avoid?
CCA decided to target a population that most insurers tried to avoid in an attempt to bring personalized and high-quality care to patients with complex needs that include both medical and behavioral health (Porter & Baron, 2008).
2. Describe CCA’s health plan in the Senior Care Plan. How does it differ from other insurance models and why?
The Senior Care Plan is for residents over 65 who have complex health needs (Porter & Baron, 2008). This plan differs from other insurance models because it frequently covers non-traditional items, including assistance with daily chores and transportation to medical appointments (Porter & Baron, 2008).
3. Describe CCA’s approach to providing care and contracting for care delivery. What is the rationale?
CCA’s approach for care delivery is to assign patients to a primary care team including a physician, nurse practitioner or physician assistant along with social workers and other support staff. The rationale for this approach is to provide a holistic and comprehensive approach to care in order to consider all aspects of patients’ needs.
4. Evaluate CCA’s overall model for elderly and disabled care. How can it be improved?
CCA’s overall model is to provide comprehensive, personalized care for patients with complex behavioral and medical health needs. It could be improved through the implementation of interdisciplinary care teams to focus on the complex health and behavioral needs of the patients (Mitchell et al., 2012).
5. What challenges and constraints will CCA have to contend with? What recommendations would you make to Dr. Master?
The primary challenge CCA will have will be to maintain the quality and individualization of care as the facility expands its enrollment and geographic area, particularly as it relates to the capital needed to expand and provide care. The primary recommendation I would make to Dr. Master is to use interdisciplinary care teams and to expand its self-management efforts to include family support.
Mitchell, P., Wynia, M., Golden, R., McNellis, B., Okun, S., Webb, C. E., … Von Kohorn, I. (2012). Core principles & values of effective team-based health care. Retrieved from https://www.nationalahec.org/pdfs/VSRT-Team-Based-Care-Principles-Values.pdf
Porter, M. E. & Baron, J. F. (2008, May 7). Commonwealth care alliance: Elderly and disabled care. Harvard Business School. Retrieved from http://humanservices.vermont.gov/dual-eligibles-project/person-centered-materials/commonwealth-case-study-elderly-and-disabled-care-12-9-11/view