• Media type: E-Article
  • Title: Partnering Managed Care and Community‐Based Services for Frail Elders: The Care Advocate Program
  • Contributor: Wilber, Kathleen H.; Allen, Douglas; Shannon, George R.; Alongi, Sam
  • Published: Wiley, 2003
  • Published in: Journal of the American Geriatrics Society, 51 (2003) 6, Seite 807-812
  • Language: English
  • DOI: 10.1046/j.1365-2389.2003.51257.x
  • ISSN: 0002-8614; 1532-5415
  • Origination:
  • Footnote:
  • Description: OBJECTIVES: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.DESIGN: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.SETTING:Three care advocates located in two community‐based social services agencies using telephone interviews to interact with targeted elders living in the community.PARTICIPANTS:Three hundred ninety PacifiCare members aged 69 to 96 receiving care from four PacifiCare‐contracted medical groups.INTERVENTION:The 12‐month intervention provides telephone assessment, links to eight types of home‐ and community‐based services, and monthly follow‐up contacts.MEASUREMENTS: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.CONCLUSION:The program builds on current insured case management services and offers a practical bridge to community‐based services.