HealthEC Blog Posts

Care Coordinators: the Glue That Holds Value-Based Care Together

By acting as an intermediary between patients and providers, care coordinators play a vital role in the delivery of healthcare. And just like diplomats translating the comments of global leaders, care coordinators translating the languages of "doctor speak" and "insurance speak" can have a significant impact – maybe not on global affairs, but certainly on patient health and the cost of care.

In fact, as more providers switch to value-based care and incorporate population health management (PHM) platforms into their organizations, the role of care coordinators has taken on added importance. Quite simply, no one else in the health care universe straddles the different worlds of doctors, insurers, administrators and patients. And with that, no one else is more qualified to address the communications gaps that exist between each group.

Once a PHM platform's risk-stratification techniques identify the most at-risk patients, care coordinators can do amazing things for providers and patients alike, which in turn, improve care and costs. Armed with an understanding of healthcare administration, care coordinators are able to cut through red tape – that is, leverage their experience working with insurers, practice administrators and patients, recognize coding abnormalities, provide key patient information that slows insurance approvals, and facilitate more efficient care.

At the same time, coordinators must overcome the challenges posed by social determinants of health – factors like socioeconomic status, language barriers and access to transportation –– an additional layer of complexity that can have a profound effect on the delivery of care.

While administrative knowledge supports the provider side of the value-based care equation, humanity is the key attribute for dealing with high-risk patients. And to ensure that care is administered at the right place, at the right time, for the right reason – compassion and patience are vital for overcoming barriers to care. With that, coordinators meet patients where they are, treat them with respect, display cultural sensitivity, and work tirelessly as relationship builders.

Balanced with an ability to listen and think critically, experienced care coordinators can effectively bridge the healthcare gaps below, which will be reviewed in future blogs:

  • Gaps in communication
  • Gaps in deployment
  • Gaps in education
  • Gaps in healthcare computer systems
  • Gaps in services
  • Gaps in contracts
  • Gaps in access to care
  • Gaps in performance
  • Gaps in relationship building
  • Gaps in data analytics
  • Gaps in healthcare programs and policies

Going back to our diplomat analogy, as population health management and value-based care evolve, care coordinators will continue to play a vital role in how health care is delivered. And with that, there’s no need for translation.

Velvet Thorne

Blogger Name: Velvet Thorne

Date of Publishing : March 28, 2018

About the Author : Velvet Thorne, a Licensed Practical Nurse and Certified Legal Nurse Consultant, is nurse care coordinator at HealthEC and AICNY LLC, with over 15 years of health care experience.