New Report Calls for Enhanced Wages, Training for Health Home/DSRIP Care Coordinators
1199 SEIU and the Primary Care Development Corporation released a report yesterday offering that offered a number of recommendations on how best to ensure a competent workforce capable of playing the care-manager and care-coordinator roles, which will be vital to ensuring the success of redesigned Medicaid initiatives like health homes and DSRIP programs. See the new release and link to the report at http://www.pcdc.org/news/press-releases/whos-going-to-care-press.html.
Here’s a brief overview based on accounts provided by Capital New York and Crain’s Health Pulse. See links below for their coverage.
The report’s central recommendations include: data should be collected on the care coordination workforce, insurers should be required to pay for care coordination services, adequate wages and benefits should be provided to employees, and additional support should be offered for workforce training.
The report, based on a survey of 49 mostly downstate New York Health Homes, which manage care of Medicaid enrollees with costly and complex chronic conditions, recommends a set of broad policy changes that in some cases would require legislative approval and, in others, would require buy-in from both providers and payers.
The report suggests that these new employees must be able to see beneficiaries in their communities or homes, often when they are still well to help manage a chronic condition, such as diabetes or hypertension, and prevent them from needing to enter a hospital. These new workers require a measure of cultural competency and a knowledge of population health, the report said.
Having the right mix of skills to find, engage and support such individuals to improve their health and wellness in a culturally competent way has been a central factor in the success of NYAPRS’ peer bridger and wellness coaching initiatives. But those skills are not enough….our experience has made clear that it’s the competency and capability to make good relationships that is the central factor. And there’s no group more capable of providing the empathy, example, hope and persistence than peers who are deployed and supervised by peer run agencies.
Increased Compensation
According to the report, 88% of the surveyed agencies said they faced at least one of several possible recruiting challenges, while 78% faced at least one significant challenge in retaining employees. Examples of challenges included insufficient salaries, high caseloads and insufficient qualifications among job candidates.
The report published the most common salary ranges paid to care coordination staff. Patient outreach and engagement staff were paid between $25,000 and $40,000. Care management staff earned $31,000 to $50,000; and supervisors earned $46,000 to $70,000.
The report calls for a wage floor to ensure skilled workers are recruited and retained, though it does not specify what that floor should be.
Enhanced Insurer Payments
It also wants all insurers to pay for care coordination services similar to how Medicare in January began paying $42 per member, per month to coordinate care for Medicare patients with two or more chronic conditions.
Workforce Training
The report emphasized a strong need for enhanced education and training for care managers that addresses their new ‘care models,’ pointing out the lack of current standards and that even the job title is “evolving.”
“If staff do not have the skills to perform well in these new care models, the models themselves are put at risk of failure,” the report said. “We may then conclude that the models were wrong or ineffective when in fact inadequate resources and attention were given to developing the workforce needed to implement them effectively.”