Medicaid Managed Care - U.S. Senate Special Committee on Aging

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Elder <strong>Care</strong> Partnership serves elderly,
- individuals with disabilities
In most capitated mnatged care programs. the enrollee must choose a physician among those associated
with the managed care organizauions netwowk While thin limihadon may not pose a problem for most
cerollees. it can be hard on the elderly and physicaly disabled, many of whom have seen a ain provider
foe many year and have chronic medical problems and multiple diagnoac.
Elder <strong>Care</strong> of Dane County. Inc. offers a solution to this problem. The Elder Car Patnnship progam.
which began in January of 1996, offers enrollees the many benefits of a managdlong term. cae program.
yet allows them to retain their primary care physician. This program is based on the Wincom Partnership
Program (WPP) model developed by the DBFS. Elder <strong>Care</strong> of Dane County. the UW School of Nursing.
and Access to Independencc.
Tbe Wisconsin Partnership Program is voluntary and serves the frail elderly and people with physical
disabilities. The program integrstes health and long term care suppeat seves and includes home and
comuity-based scavices. physician services, and all other medical care. Te program targets those who -
are nursing-home, eligible yet who would li}e to remain in their homes.
A key element in the Elder <strong>Care</strong> Partnership progrnm is the team-based approach to cam management.
Four corc team members coordiate ctue for each Partnership enrollee. bea tem- members and their
primary responsibilities are outlined below-
Primary <strong>Care</strong> Physician -Provides primary health care nd tspesvises al medical interventon
performed by the nurse practitioner.
Nnrse Practitioner -Conducts assessmcats, participates in care plan development monirs ongoing
clinical staus, responds immediately to acute mae problems. provides participantIao-giver education,
and acts as the liaison between the primasy are physician endthe rem of the t
* Social Worker -Conducts psychosocial and economic a nts manages referrals. counsols and
coordinates community services.
* Hame <strong>Care</strong> Nmrse -Conducts assessments of functional limitations and safety istes; and supervises
personal care workers in the home.
The cighty-plus individuals who me ctnently cmroled in the Elder <strong>Care</strong> Partnership gingram have an
average of eight chronic conditions and take an average of six medicaions We ty to mn their
symptoms in such a way that the person can be carId for in the community, despite the medical
conditions." Elder <strong>Care</strong>'s Executive Die34r Jim Kelenman said
Those eligible for Elder <strong>Care</strong> Partnership imclude fra elderly and disabled persons who are 55 years or
older, iiveinDaneCounty. havchroicmedical conditions needsssistane to y at hoe and are
financially eligible.
Elder <strong>Care</strong> of Dane County is responsible for all daily adminisrative and c l aspecs of Elder <strong>Care</strong>
Partnership, including maintaining contracts with all participating physicians and odter providers, tbus
offering a full scope of health care and long-ternm supportarvicesz