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Insurer Trains Nurse Care Coordinators

John Commins, for HealthLeaders Media, February 13, 2012

The Horizon project courses will focus on:

  • Case management of patients with complex health conditions
  • Engagement and communication strategies with patients
  • Using databases, including disease registries and Electronic Medical Records
  • Coordinating care of "frequent flier" patients and discharged from care facilities
  • Implementing and managing change in healthcare organizations
  • Operations of a PCMH
  • Role of care coordinators in improving patient care and patient experience in a PCMH

The announcements from WellPoint and Horizon should be welcomed by  anyone who cares about healthcare reform and the move toward the patient-centered medical home. If the commercial plans aren't on board, it's not going to work.

The initiatives also show that payers clearly understand that ongoing political dog fights and the court challenges to "ObamaCare" are just static. The plans know that regardless of who gets elected president, or who controls Congress, or which way the U.S. Supreme Court rules, there is no going back to the old fee-for-service model. It is simply too wasteful, and too unaffordable.

The plans are planting a stake on the future of healthcare and they're betting that primary care physicians and nurses will lead the way.


John Commins is a senior editor with HealthLeaders Media.

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1 comments on "Insurer Trains Nurse Care Coordinators"


Mary Beth Newman (2/16/2012 at 1:34 PM)
This is absolutely what best-practice case management is all about. So why not just call it what it is[INVALID]case management? Nurse case managers bring a skill set to the table that is unparalleled in terms of their knowledge and experience with care coordination, advocacy, planning, and facilitation across care settings and patient populations. We fail to appreciate the value case management brings to new models of health care because we are allowing it to be constantly renamed and rebranded across business settings.