NavCareNet.com Blog

New CPC+ Program Adds Strength to Primary Care Model

Posted by Dr. Joseph F. West on Jun 30, 2016 2:00:00 PM

Earlier this year the Centers for Medicare and Medicaid Services (CMS) unveiled Comprehensive Primary Care Plus (CPC+) in an effort to strengthen primary care services through a regionally-based multi-payer payment reform and care delivery transformation. CPC+ is a new advanced primary care model. Set to begin in January 2017, CPC+ will reward quality and value through modified payment structure supporting primary care.

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Topics: Chronic Care Management, Comprehensive Primary Care Plus (CPC+), Care Coordination, CCM

Opioids and Chronic Pain Management

Posted by Dr. Joseph F. West on Jun 28, 2016 4:30:00 PM

Patients managing chronic and complex conditions are often also trying to control chronic pain. Proper pain monitoring and routine medication review can prevent abuse of drugs, particularly opioids, alcohol or other substances. Care coordination entails instruction for appropriate use of pain medications, timely scheduling of appointments, ensuring prescription refills, and important preventive health reminders. It also includes providing chronic care patients with the right pharmacological and psychological treatment options and information for effective self-care.

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Topics: Chronic Care Management, TCM, Chronic Pain Management, CCM

Transitional Care: A Team Approach for Better Care

Posted by Dr. Joseph F. West on Jun 21, 2016 3:30:00 PM

Moving a patient from a hospital to their home or care facility in a community setting is a delicate process. Patients, family members or caregivers can receive confusing recommendations, a laundry list of medications, and conflicting instructions regarding follow-up care. If they are not included in planning or provided with clear “next steps” there can be significant gaps in post-discharge care. As a result, patients will most likely return to the hospital, and often times with more complications than before.

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Topics: Chronic Care Management, Transitional Care Management, Population Health Management, Senior Health

Addressing Social Determinants Through Care Coordination

Posted by Dr. Joseph F. West on Jun 7, 2016 5:45:27 PM

Social conditions and chronic disease are related. Overcoming social factors can be a challenge for the two-thirds of Medicare beneficiaries with two or more chronic conditions. Many of these patients struggle with housing concerns, lack of access to transportation, inadequate nutrition, and job loss. Some are isolated from family and face fragmented care.

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Topics: Chronic Care Management, Senior Health, Care Coordination

Never Too Old to Quit

Posted by Dr. Joseph F. West on May 31, 2016 1:00:00 PM

You may ask yourself—Is it possible for me to help my senior patients quit smoking? After years of addiction and attempts can they really overcome the challenges? The answer is YES! In fact, eliminating harmful tobacco use is essential to chronic care management. There are so many ways to help your patients quit. Yes, smoking cessation can be an uphill battle, but your patients don’t have to fight it alone. Changing deeply engrained behavioral habits and addictions can be more difficult for older patients. However, these patients may be more responsive to reminders of more personal reasons to quit. For example, grandchildren, children, spouse, friends or simply feeling better themselves.

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Topics: Chronic Care Management, Population Health Management, Smoking Cessation


A resource for physicians and health systems, and a place for innovative ideas

This blog allows us the opportunity to share insights into unique information, news and updates, as well as provide a place to interact with you. As a care management organization, our blogs will take you through the many facets of care management, from chronic care and transitional care management, to population health management which is where we begin.

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