Models of Care: Overview & Types - Lesson | Study.com (2024)

Lesson Transcript

InstructorColleen LeveretteShow bio

Colleen is a certified rehabilitation counselor and has a master's degree in rehabilitation counseling and an Ed.S. in counseling.

Models of care are often used in settings that provide medical and case management services. Case managers must be knowledgeable of models of care such as the Home Health Model, the Chronic Care Model, and the Special Needs Plan. In this lesson, we will explore the basics of these models.Updated: 10/23/2022

Table of Contents

  • What Is a Model of Care?
  • Health Home Model
  • Special Needs Plan
  • Chronic Care Model
  • Lesson Summary
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Models of care are used in a variety of healthcare settings to provide guidance and direction on how to successfully deliver services to the population served. Many case managers work in healthcare settings such as home care, nursing homes, and hospitals, and provide services such as resource management, service facilitation, and advocacy. For medical and healthcare facilities or agencies and their case managers to successfully provide services to their clients or patients, they examine, select, and implement models of care. Some of the most commonly used models of care are the Health Home Model, the Special Needs Plan Model, and the Chronic Care Model.

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  • 0:04 What Is a Model of Care?
  • 0:44 Health Home Model
  • 2:24 Special Needs Plan
  • 3:10 Chronic Care Model
  • 3:50 Lesson Summary

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The Health Home Model is also referred to as the Patient-Centered Medical Home Model (or PCMH), the Advanced Primary Care Model, or the Primary Care Medical Home Model. The following are the defining features of this model:

  • Accessible
  • Committed to quality and safety
  • Coordinated
  • Patient-centered
  • Comprehensive

The accessible feature of this model means that the services the healthcare entity provides are readily available to patients. This can include 24/7 telephonic access to certain services and information, after-hours help, telehealth options, and shorter wait times. The component of this model committed to quality and safety places an emphasis on the health entity prioritizing quality improvement and the informed choice of patients and their families. The coordination aspect of this model refers to the collaborative efforts needed to provide the best quality care to patients. This includes collaborating with organizations that provide specialty care, other hospitals, and community or social agencies.

The home health model is patient-centered because it values the needs, best interests, and autonomy of patients. This is visible in the decision-making process that occurs during the pre-treatment, treatment, and post-treatment processes and involves collaboration between patients, support systems such as families, medical staff, other organizations and agencies, etc. Lastly, it's comprehensive because it involves the coordination of interdisciplinary services such as mental health, acute care, and prevention that are needed to provide the adequate care for patients.

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A Special Needs Plan (or SNP) is a plan provided by the Centers for Medicare and Medicaid Services (CMS) that is specially designed for individuals who are institutionalized, have a chronic condition that is disabling or severe, or someone who is dual eligible. Accordingly, the three SNP plans are Chronic Condition (C-SNP), Dual Eligible (D-SNP), and Institutional (I-SNP). It's important to note that individuals who qualify for this type of plan must fall under the Centers for Medicare and Medicaid Services' (CMS) definition of special needs. All types of Medicare Advantage (MA) care coordinated plans (CCP) cover SNP plans.

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The Chronic Care Model is a comprehensive model that's designed to address the needs of those with chronic conditions such as cancer, heart disease, and diabetes. This model places an emphasis on the inclusion and coordination of the following aspects of a healthcare process:

  • Decision support
  • Clinical systems design
  • Self-management support
  • The community
  • Delivery systems design
  • The healthcare system

It's important to note that the application of the Chronic Care Model or any of the other previously-discussed models will be tailored to fulfill the needs, goals, and missions of each healthcare entity or facility.

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All right, let's now take a moment to review. There are several models of care that can be used by agencies that provide medical and case management services. The Home Health Model is also known as the Patient Centered Medical Home (PCMH) Model, the Advanced Primary Care Model, or the Primary Care Medical Home Model. The model is accessible, committed to quality and safety, coordinated, patient-centered, and comprehensive.

The Special Needs Plan (SNP) is a plan provided by the Centers for Medicare and Medicaid Services (CMS) that's specially designed for individuals who are institutionalized, have a chronic condition that is disabling or severe, or someone who is dual eligible. The three SNP plans are Chronic Condition (C-SNP), Dual Eligible (D-SNP), and Institutional (I-SNP).

Finally, the Chronic Care Model addresses the needs of those with chronic conditions such as cancer, heart disease, and diabetes. It involves the integration of these elements: decision support, clinical systems design, self-management support, the community, delivery systems design, and the healthcare system.

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Models of Care: Overview & Types - Lesson | Study.com (2024)

FAQs

What are the types of models of care? ›

Some of the most commonly used models of care are the Health Home Model, the Special Needs Plan Model, and the Chronic Care Model.

What are the 4 models of nursing care? ›

There are four nursing work methods identified: functional nursing, individual, team nursing, and primary nursing.

What are the overall goals of the model of care? ›

Increase member satisfaction of care. Increase quality outcomes of care. Improve provider quality of life. Decrease health care costs.

What are the five models of healthcare systems? ›

The healthcare systems utilized by the Western world include the Beveridge model, the Bismarck model, the national health insurance model, and, lastly, the out-of-pocket model. The United States utilizes a blend of these four models.

What is the care model process? ›

Care modeling is the continuous process of (1) defining a care model, (2) operationalizing it by deploying technology and training people, and (3) updating it with feedback on an ongoing basis and with the goal of creating more health among the persons served.

What is the most common nursing care model? ›

#1 Primary Care Nursing

Primary Care Nursing is a patient-centered model that prioritizes the nurse-patient relationship's importance. We all know how important it is to feel seen by your healthcare providers – primary care nursing targets that. The goal of the model is for patients to know and trust their nurses.

Which concepts are included in a nursing model of care? ›

Four major concepts are frequently interrelated and fundamental to nursing theory: person, environment, health, and nursing. These four are collectively referred to as metaparadigm for nursing. Person, Nursing, Environment, and Health – the four main concepts that make up the nursing metaparadigm.

What are new care models? ›

Developed by the National Association of Primary Care (NAPC), and supported by NHS England, the model brings together a range of health and social care professionals to work together to provide enhanced personalised and preventative care for their local community.

Why are care models important in nursing? ›

It guides nurses in the implementation of their tasks and duties. It provides structure to their work shift amidst the sometimes-chaotic backdrop of multiple clinicians of different types giving different services and care to patients. There have been several nursing care models developed and used over the years.

What does the care model stand for? ›

The CARE Model (Pearce, 2016) offers an evidence-informed conceptual framework for supporting individual and organisational focus on key aspects of caregiving and relating that influence outcomes developmental outcomes and recovery from adversity. CARE stands for: Consistency. Accessibility. Responsiveness.

What is the standard of care model? ›

As discussed above, the standard of care is basically what a reasonably prudent similar healthcare provider would do under similar circ*mstances. In light of this, there is flexibility for the standard of care to be tailored to the specific circ*mstances, such as with an emergency or other disaster.

What is the social model of care? ›

The social model seeks to remove unnecessary barriers which prevent disabled people participating in society, accessing work and living independently. The social model asks what can be done to remove barriers to inclusion.

What is the most commonly used model of care in the ICU? ›

Primary nursing is the most commonly used model of care in the ICUS.

What are the three primary goals of a healthcare system? ›

Therefore, health systems have three independent outcome-oriented objectives: health utility, process utility, and financial fairness.

What are the six models of managed care? ›

The six managed care model categories include HMO, PPO, EPO, POS (Point of Service), IPA (Independent Practice Association), and ACO (Accountable Care Organization).

What are the models of care coordination? ›

Care coordination models usually involve systematic strategies that aim to improve continuity and bridge transitions of care. Often, this takes the form of care or case management, in which a designated person or team helps patients manage their medical care and navigate interactions with the health care system(s).

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