Population Care Coordinators: A Key to Improved Care at Lower Cost?

In New Jersey, Horizon’s patient-centered medical home program puts data-savvy nurses in primary care practices to reach out to high-risk patients and forestall costly crises

Trying to save money in health care isn’t new to Sandra Siegel, RN. A nurse with 30 years’ experience, she remembers working for a managed care company in the ’90s doing precertifications and checking hospital stays.

“I worked with algorithms that said things like, ‘Patient A is going to have this surgery and get four days in the hospital,’” she recalls. “And if the person didn’t go home in four days, I had to figure out why. It was very, very stressful.” Today Siegel has a job she likes much better. And there’s every chance she’s saving more health care dollars now than she did back in the bad old days.

Siegel is a population care coordinator employed by Hunterdon Healthcare Partners (HHP), a for-profit arm of Hunterdon Medical Center in Flemington, N.J., that manages its integrated delivery system and forms an accountable care organization (ACO) under the Affordable Care Act (ACA).

Though HHP cuts her paycheck, Siegel is closely linked to two other entities: She spends her days “embedded” in a Hillsborough, N.J.-based primary care practice called Your Doctors Care, and she’s part of an initiative sponsored by Horizon Blue Cross Blue Shield of New Jersey, the Garden State’s largest health insurer with 3.7 million members.

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