Explorations of the long term supports coordinator role in managed care for people who are dually eligible for Medicare and Medicaid: A participatory action research-informed study.

IF 3.7 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Disability and Health Journal Pub Date : 2025-02-22 DOI:10.1016/j.dhjo.2025.101782

Kimberly J The, Maggie Sheets, Shulamith Acevedo, Emily Almeda-Lopez, Nancy Garr-Colzie, Luanjiao Aggie Hu, Dennis Heaphy

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引用次数: 0

Abstract

Background: This article evaluates a role, the Long Term Services and Supports (LTS) Coordinator in a program (called One Care) for dually eligible individuals who have Medicare and Medicaid.

Objective: Examine the implementation of the LTS Coordinator role within the One Care demonstration project and assess its strengths and areas for improvement.

Methods: This study utilizes thematic analysis²⁵ and is informed by participatory action research¹⁹. One Care members (n = 27), LTS Coordinators (n = 4), and One Care health plans' staff members (n = 6) were recruited via convenience sampling. Semi-structured interviews were used for data collection.

Results: Participants felt supported and understood by their LTS Coordinators, which was helpful in combating isolation and loneliness. LTS Coordinators filled gaps in care related to social determinants of health. However, stakeholders had mixed understandings and definitions of the role of LTS Coordinators. Participants indicated the need for more resources for the LTS Coordinators.

Conclusions: The LTS Coordinator is a unique and innovative role in the One Care duals demonstration. The role of the LTS Coordinator can be strengthened by clarifying the LTS Coordinator role, integrating them within the care team, and improving training and compensation. The LTS Coordinator feature of One Care can serve as a model for other integrated care programs.

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背景：本文评估了一项计划（名为 "一体护理"）中的长期服务与支持协调员这一角色，该计划针对的是同时符合医疗保险和医疗补助资格的个人：研究 "一体护理 "示范项目中长期服务与支持协调员角色的实施情况，并评估其优势和需要改进的地方：本研究采用主题分析法25 ，并借鉴了参与式行动研究19 的方法。通过便利抽样招募了 One Care 会员（n = 27）、LTS 协调员（n = 4）和 One Care 健康计划的工作人员（n = 6）。采用半结构式访谈收集数据：结果：参与者感觉到了他们的 LTS 协调员对他们的支持和理解，这有助于消除孤独和寂寞。LTS 协调员填补了与健康的社会决定因素相关的护理空白。然而，利益相关者对长者服务协调者角色的理解和定义不尽相同。与会者表示需要为长者服务协调员提供更多资源：在 "一体护理 "双重示范项目中，长期治疗服务协调员是一个独特而创新的角色。可以通过明确 LTS 协调员的角色、将其纳入护理团队以及改善培训和报酬来加强 LTS 协调员的作用。一体护理 "的 LTS 协调员功能可作为其他综合护理计划的典范。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Disability and Health Journal HEALTH CARE SCIENCES & SERVICES-PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

CiteScore

7.50

自引率

6.70%

发文量

134

审稿时长

34 days

期刊介绍： Disability and Health Journal is a scientific, scholarly, and multidisciplinary journal for reporting original contributions that advance knowledge in disability and health. Topics may be related to global health, quality of life, and specific health conditions as they relate to disability. Such contributions include: • Reports of empirical research on the characteristics of persons with disabilities, environment, health outcomes, and determinants of health • Reports of empirical research on the Systematic or other evidence-based reviews and tightly conceived theoretical interpretations of research literature • Reports of empirical research on the Evaluative research on new interventions, technologies, and programs • Reports of empirical research on the Reports on issues or policies affecting the health and/or quality of life for persons with disabilities, using a scientific base.