CARE SUPPORT OF AMERICA’S PROVEN
ADVANCED ILLNESS COORDINATED CARE PROGRAM
Care Support of America (CSA) is partnering with leading payers and hospitals to offer its proven health counseling and care coordination algorithms to patients and families facing advancing illness. The program has been shown to reduce hospitalizations with no increase in mortality, as well as increase the quality of life for patients and families.
What CSA’s Program Provides
CSA’s program provides 3 months of an experienced RN on the phone utilizing proven advanced illness/palliative care health counseling algorithms and a community nurse visiting the patient’s home to assess home safety in a proactive manner. The program integrates with existing case managers, discharge planners and community physicians, as well as with the patient’s family.
How It Works
Identification
- Patients are identified for the program through direct referral from plan case managers, physician offices and hospital discharge planners, as well as through predictive modeling employing existing data.
Engagement
- The CSA program, branded as Advanced Illness Coordinated Care (AICC) to the public and physicians, is introduced by plan correspondence.
- Patients and family are engaged and oriented to the service by customer support staff in a HIPAA compliant manner.
- Patients and family are paired with their own experienced registered nurse for individual assessment and care.
- CSA nurses are specially trained to rapidly develop highly effective working relationships that engage patients and families in strengths-based problem-solving.
- Continually evaluating and improving practice outcomes
- Focusing eldercare with a reverence for aging
- High-engagement philanthropy
Intervention
- Services begin with an initial telephone assessment by a CSA nurse involving the patient and primary family caregiver, followed by an in-home safety assessment. CSA has a national contract with Interim Healthcare, as well as other private duty companies, to provide CSA’s in-home safety assessments.
- The CSA nurse works with the patient and family caregivers to develop an individualized problem list and care plan. CSA’s non-directive health counseling algorithms, derived from relationship-based, psychodynamically-oriented nursing, help the patient and family:
- Clearly define, prioritize and address problems
- Organize care
- Understand the illness
- Cope
- Plan for future needs
Outcomes
- A summary of program outcomes from CSA’s peer-reviewed publications can be found in the Who We Are section.
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Talk with a Family Care Manager
866-439-7103
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