Once upon a time, when a person was injured or ill, she went to the doctor hoping to be cured. In those days, the patient was a bit player; the main roles belonged to the doctor and his adversary, the condition needing a cure.
Of course, some conditions could not be cured and required long-term palliative care. Often, those with the most severe conditions were put in institutions where care could be accessed as needed day or night. Over time, as the cost of this kind of care became prohibitively expensive and people in institutions challenged the notion that they were better off away from their homes and communities, a new, more person-centered model of care was born.
Independence Care System is both an inheritor of and an innovator in the person-centered model of care. Our first members, when ICS opened its doors in 2000, were adults with disabilities and chronic conditions, eligible for Medicaid, who wanted a coordinated care system that worked for them on their own terms. ICS coordinated the services that enabled our members to live at home and in their communities as independently as possible. The ICS Community Care MLTC (managed long-term care) plan now also serves a large population of seniors enrolled in Medicaid who need long-term home-based care.
In January, we launched an integrated Medicare-Medicaid plan (MMP), ICS Community Care Plus FIDA-MMP, as part of a demonstration project designed to coordinate care for people who are eligible for both Medicare and Medicaid. We and our partners in state and federal government believe that the FIDA (Fully Integrated Duals Advantage) plan, which provides participants with the full range of care (vision, dental, personal assistance, behavioral health, primary and acute care, hospitalizations, home care, durable medical equipment, etc.) is the future of long-term care.
Participating in Your Care
A major goal of our FIDA plan is to keep participants healthy and out of the emergency room and hospital. Sounds like any other health plan, right. But unlike other plans, FIDA puts the participant on a team specifically dedicated to these goals.
Lots of health care plans talk about empowering their members, but if you are a participant in our FIDA plan, assisted by your care manager, you will build and serve on your own interdisciplinary team (IDT) and collaborate on creating your unique person-centered service plan (PCSP), which lays out how your health care needs will be coordinated. This is not just an honorary position: If you are a FIDA member, you’ll meet with your IDT at least twice a year to go over the PCSP and make sure you’re meeting your goals, whether it’s keeping your skin free of pressure sores, your bladder free of urinary tract infections, your days free of dangerous falls, or all of the above.
In February, Senior VP of Communications and Marketing Loreen Loonie shared on this blog her experience with end-of-life care decisions and how important it is for us to talk about these important choices and preferences with our families and friends, with doctors, care managers and any one sympathetic to our needs, so they can know what we want if we are too ill or incapacitated to tell them. Equally important is having in place an advance directive that puts your wishes in writing.
Just as advance directives help you control your end-of-life choices, IDTs help you control the services you need to stay healthy, bringing you together with your ICS care manager, your health care professionals and others important in your life, to talk about your care and make decisions together.
Maybe this sounds like a lot of work. Don’t worry: being on a team means you won’t be doing it alone. Your care manager will help you every step of the way, from helping you select your teammates to setting up the time and place of the meetings. Along with your care manager, you will need to include your primary care physician, the medical professional who knows your all-around health the best. This may be a general practitioner with an MD, a nurse practitioner, or physician’s assistant—whoever you trust most to advise you on big and small care decisions. In addition, you may want to include a specialist, such as a neurologist or physiatrist, who has worked closely with you. You may also include a behavioral health provider, your home health aide, the nurse who handles your assessments, members of your family or friends who care about your health. It’s your choice who’s on your team.
Not only will you be able to meet with your IDT, your PCSP will help you track your medications, supplies and services and plan for any tests or procedures you need in the next half year. It will be designed for your unique needs, and you will be able to reference it whenever you need to.
Does this sound like a new way of doing health care? Well, it is. It’s so new, in fact, that everyone participating in it—you, your doctor, your care manager, etc.–is entering new territory every step of the way. On this National Healthcare Decisions Day, we are confident that it’s a worthwhile path to your good health and independence because it puts you in charge and at the center of your care planning.