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Chronic Healthcare Management Policy

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Chronic Care Management Policy
Health and well-being not only affects individuals it has an impact on society as a whole. Policies that address health are formal guidelines created to enhance health by directing actions of the healthcare delivery. The goal of these policies is to improve the overall health of the community as a whole. With the passage of the Affordable Care Act, healthcare will likely never be the same. Medicare guidelines steer the approaches taken by healthcare organizations. New changes in policy have a focus on prevention and disease management that are designed to decrease hospital readmission and increase community health.
Health Disparity Inconsistencies in healthcare delivery is considered health disparity. …show more content…

This is proving to be inefficient and costly to healthcare and society as a whole (Lupari, Coats, Adamson & Crealy, 2011). Many former hospital based services including management of newly diagnosed diabetes is managed in ambulatory care (Haughton & Stang, 2012). There is a policy that has recently developed will have a huge impact on primary care nursing. In primary care Medicare reimbursement historically has been based on physical contact patients. The more patients seen the more revenue for a practice. This creates a dilemma because a small portion of primary care occurs in the actual face-to-face visit. Managing patients in primary care involves patient referrals, contact with specialists, lab monitoring and interpretation, medication management, compliance concerns, not to mention electronic communication with patients. There is a substantial amount of time outside of office visits spent in respect to the coordination of care for patients in particular patients with chronic …show more content…

With regard to Chronic Care Management there is a broad spectrum of stakeholders including physicians, nurses, the organizations they work for, patients with chronic conditions, and Medicare. Hospital readmission rates may decline. Physicians and organizations are likely to see an increase in revenue. Nurses will increasingly become even more valuable to the healthcare team. Patients will have an increase in compliance with the coordination of care involved in CCM. It is possible that Medicare will spend less due to the possibility of decrease

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It was developed by Wagner and his colleagues as a framework for guiding specific quality improvement strategies (Bowen et al., 2010; Fiandt, 2006). The goal of CCM is for productive encounters between patients and their healthcare professionals leading to care which is safe, effective, timely and patient focus, efficient and equitable (Institute of Medicine,2001; Wagner et al., 2001). The CCM consists of six core concepts (Appendix 1). Components related to the clinical practice level are: delivery system design, decision support, clinical information systems, self-management supports, and healthcare organization, leadership and community resources are related to the large health system. Chronic disease management can be centred on individual aspects or on the model as a whole, however, it is important to keep all components in mind (Bowen et al., 2010;

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This model is interesting because it is one of the most commonly used models and was created within the clinical setting. The Chronic Care Model (CCM) is primarily patient-focused and was created to improve the care of patients with chronic medical conditions by allowing the patient to have

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