Through CHOICES (Comprehensive Home-based Options for Informed Consent about End-Stage Services), Emeryville, CA, Medicare risk patients served by North American Medical Management (NAMM), a managed care group, are invited to receive services from a geriatric nurse practitioner, patient care coordinator and care physician.
In addition to the comprehensive services available to all patients, those patients enrolled in CHOICES receive home-based services including comprehensive medical/psychosocial assessment, coordination, advance care planning, communication of preferences to providers, and end-of-life services. The team provides special palliative care, focusing on comfort as well as the psychological, social and spiritual well-being of patients and families.
NAMM physicians in two Physician Organized Delivery Systems (PODS) have received palliative care training and use clinical indicators to identify patients who are within two years of death, medically unstable, and at risk of receiving potentially unwanted emergency and inpatient services. After this initial introduction of CHOICES, the program will expand to additional PODS in the North American Medical Management system.
Alta Bates Medical Center, as a collaborator in the project, ensures that the ABMC's Emergency Department and discharge planners have timely information about the advance directives and treatment preferences of CHOICES patients.
Under the direction of Brad Stuart, MD, and Carol D'Onofrio, DrPH, the project measures access to end-of-life care, services provided and cost of care to demonstrate that the CHOICES program can be implemented in a managed care environment.
For information on this project's evaluation process visit the Evaluation and Measurement area of this web site.
Brad Stuart, MD and Carol
D’Onofrio, Dr.P.H.
Sutter VNA and Hospice
1110 North Dutton
Avenue
Santa Rosa, CA 95401
Phone: 800.861.1715
Fax: 707.887.7609
Email: BRADSTUART@msn.com
Email:
cnd@uclink4.berkeley.edu
