Evaluation of a Chronic Care Management Model for Improving Efficiency and Fiscal Sustainability - PMC

Evaluation of a Chronic Care Management Model for Improving Efficiency and Fiscal Sustainability - PMC

Chronic care management is effective. Barriers to program durability include dependence on the provider–nurse duo to carry out labor-intensive services and the lack of a fiscally sustainable model. Between January and October 2022, an expanded chronic care management team—consisting of a provider, nurse, community health worker, and pharmacist—conducted a four-month intervention in an ambulatory setting. 

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A team-based chronic care model combining physicians, nurses, community health workers and pharmacists showed promise in improving disease-control and reducing provider burden — a structure that U.S. clinics might adopt to better manage growing chronic-disease loads.


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