Patient Care Coordination

At East Adams Rural Healthcare, we understand that navigating the medical system can be overwhelming and confusing for many patients. Because we genuinely care about the well-being of everyone who enters our doors, we provide patient care coordination services for anyone who needs them.

You can schedule a one-on-one appointment with a care coordination specialist who can answer all your questions and provide resources that can help you with your medical and health needs.

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What Is Patient Care Coordination?

Patient care coordination is a process that helps patients get the care they need, when they need it, and in the most efficient way possible. It involves a team of healthcare professionals who work together to assess the patient’s needs, develop a care plan, and track the patient’s progress.

Patient Care Coordination at East Adams Rural Healthcare

East Adams Rural Healthcare provides patient care coordination throughout our organization, including our hospital and clinics, and with our partnering agencies.

We provide coordination of care through a team of professionals that may include nurses, social workers, case managers, and care coordinators.

When Should You Seek Patient Care Coordination?

Our staff is ready and able to assist any patient with specific medical needs, whether it’s helping with self-management of certain conditions or diseases or adapting to lifestyle changes designed to reduce health risks.

While any EARH patient can take advantage of patient care coordination, most fall under one of the following categories:

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Patients needing a Medicare annual wellness visit

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High-risk and chronically ill patients

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Patients adjusting to lifestyle changes for health reasons

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Patients with complex medical conditions such as multiple disabilities

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Patients who are receiving home healthcare

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Patients who are uninsured or underinsured

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Patients who have difficulty navigating the healthcare system or have limited English proficiency

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Patients who are discharged from the hospital

Benefits of Coordination of Care

Patient care can be a complex process. At East Adams Rural Healthcare, we strive to make it as easy as possible for our patients.

Our aim is to provide as many benefits as possible for each patient, including:

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Improving the quality of their care

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Minimizing patient costs

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Maximizing patient satisfaction

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Achieving the best possible patient outcomes

Chronic Care Management

Chronic care management (CCM) helps people with chronic diseases manage their conditions and improve their health outcomes. East Adams Rural Healthcare provides CCM through a variety of caring professionals including nurses, social workers, and pharmacists.

When you depend on EARH for your chronic care management, it typically includes the following steps:

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Assessment

Assessing the patient's health status, including their chronic conditions, medications, and risk factors

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A Care Plan

Developing a care plan for the patient's medical needs, such as medication management or referrals to other healthcare providers

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Set Goals

Setting individual health goals for each patient, which may involve things like improving blood sugar control, losing weight, or reducing their risk of falls

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Individual Support

Providing emotional and practical support to the patient and their family

Annual Wellness Visits

Did you know that Medicare covers a one-time “Welcome to Medicare” preventive screening visit and an annual wellness visit? Both of these visits have no co-pay or deductibles applied and are a great way to improve your health.

A typical wellness visit includes:

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A complete health history review

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Checking blood pressure, weight, and vision

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Screenings that detect depression, falling risks, or other potential problems

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Recommendations for other wellness services and healthy lifestyle changes