Wednesday, November 14, 2018

Next Generation Healthcare and the Gerontological NP

Guest blog by Catherine Burger.

Health teams working in the unique field of managed care are challenged with getting and keeping patients involved in their own health-care planning. As more regulatory agencies throw their hat in the ring of medicine, care teams such as nurses, social workers, nurse practitioners, physician assistants and physicians are tasked with improving outcomes for patients who may not wish to make changes to their unhealthy lifestyles. How can managed care providers bridge the gap between mandated care plans that improve health conditions and the lack of patient engagement in their own health outcomes?

Numerous studies have shown that the more engaged a patient is in their healthcare, the more likely they are to have better health outcomes, even for chronic conditions such as heart failure or diabetes. Conversely, patients who fail to recognize the value of improving their health or even acknowledging their poor health status decline at a much higher rate than patients who are involved, or even perceive that they are involved, with their healthcare. Agencies such as Geographic Managed Care (GMC), under the Department of Health Care Services in Sacramento and San Diego, California have designed regulated systems to put healthcare teams in place to connect with high-risk, low-income patients to assess their health and offer federal and community resources with the expectation of improving the health of this population.

The first major hurdle for managed care programs is to identify where the patient falls in the long list of criteria and placement. For example, under the GMC model, patients who belong to an HMO such as Kaiser Permanente do not fall under the care plan model nor do patients who have had a major organ transplant. However, patients who are dual covered with Medicare and Medicaid can elect to enroll in the care plan management program. Organizations typically assign a taskforce of personnel to ensure managed care populations are meeting all of the required regulatory requirements for touchpoints and resources, but first must validate where, in the complicated system, the patient belongs.

Some managed care nurses are responsible to capture health data for the patient via an annual care plan for GMC, have much fewer connections with the patients than other disciplines such as a Licensed Clinical Social Worker (LCSW) or Medical Social Worker (MSW). These specialists are able to offer resources to the patients and assist with their healthcare needs by setting short, actionable items that can drive engagement. Depending on the population, many patients in the managed care programs do not have the capacity to change their health outcomes alone. They need a health partner, such as an LCSW, to provide a direct solution (an appointment with a specialist) along with the resources (arranging transportation), in order to become engaged in improving their health.

Patients who have a relationship with their primary clinician are more likely to adhere to recommendations by the provider for healthy lifestyle changes. When a physician, physician assistant or nurse practitioner takes time to connect with the patient or family and makes recommendations towards health improvements such as quitting smoking, losing weight or tracking blood glucose levels, studies show that patients are significantly more likely to follow through than when the information is provided by other disciplines. Furthermore, age-related specialist such as an Adult Gerontology Nurse Practitioner are usually willing to dig a little deeper into the cause of health concerns given their breadth of knowledge of the aged patient population which, ideally, allows for a deeper connection with the patient and family. When connections are made, and trust is established, the patient is more likely to adhere to a plan of care that could mean considerable changes in lifestyle.

The more engaged the healthcare team is with the managed care patients, the more engaged the patient will be in improving their health outcomes. In spite of the high volume of workload in managed care settings and the seemingly low involvement of the patients or families in their own health matters, engagement from the medical team can directly make the largest impact to this complex and fragile group of patients. By improving the overall health of this population, we can drive down the cost of healthcare to our cities, counties and the nation. 

Tuesday, August 14, 2018

Classes at Chamberlain University begin September 3th!

Members of AAMCN have the opportunity to take advantage of an Educational Partnership with Chamberlain University. Chamberlain offers the following online nursing degree programs and options:
(Program availability varies by state)

  • RN to BSN Degree Completion Option
  • RN-BSN to MSN Option
  • Master of Science in Nursing (MSN) Degree Program
  • Graduate Certificate Programs
  • Doctor of Nursing Practice (DNP) Program
  • Chamberlain also offers a Master of Public Health (MPH) degree program for nurses and non-nurses.

For more information please call or email Debbie: 949.633.7181 or

·   AAMCN member education benefits, including:
o   A group-specific tuition rate, a 10% tuition savings
o   Waived application fee
o   Complimentary transcript request and evaluation service upon completing an application for admission
·   How online learning at Chamberlain works, including:
o   Degree program requirements
o   General course structure
o   Participation requirements