Abstract

The quest to reduce costs and readmissions has given rise to system- and practice-level approaches to identifying and managing the care of high-cost, high-risk populations.1 Care management programs (CMPs) have been developed in US health systems to connect nurses, social workers, and/or other staff with patients to coordinate care, reduce utilization, and lower costs, but evidence of success in cost reduction is variable.2, 3 Early models featured registered nurses as care managers, although more recent reports show models led by social workers.4 We aimed to develop approaches to classifying models of care management in Medicare ACOs that included staffing, CMP process, and outcomes.

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