Case management in a capitated system: the community nursing organization

Area of Science:

• Nursing care models
• Health services research
• Geriatric healthcare

Background:

• The Community Nursing Organization (CNO) is a federal healthcare model.
• It offers ambulatory and outpatient services to Medicare beneficiaries.
• The model utilizes a nurse-managed delivery system with capitated financing.

Observation:

• A primary nurse provider assesses care needs for elderly clients.
• The nurse collaborates with clients, families, physicians, and community organizations.
• The nurse also authorizes payment for CNO-covered services.

Findings:

• A 3-year demonstration project is currently in progress.
• One-year findings indicate a potential positive effect on client health status.
• The nurse-managed system may improve health outcomes for Medicare beneficiaries.

Implications:

• This model could offer a new approach to geriatric care delivery.
• Capitated financing and nurse management may enhance efficiency.
• Further research is needed to confirm long-term benefits and scalability.