Care Coordination - Medicare Pilot Program for Asbestos Related Disease

One of the key components of the Medicare Pilot Program for Asbestos Related Disease is care coordination. Care coordination helps ensure a patient’s needs and preferences for care are understood, and that these needs and preferences are shared between providers, patients, and families as a patient moves from one healthcare setting to another. Well-coordinated care avoids waste, over-, under-, or misuse of prescribed medications, medical treatments and care, as well as conflicting plans of care.

Care coordination activities will be performed by various Noridian pilot staff, but is the main responsibility of our nursing staff who will use their clinical and nursing experience to help Medicare beneficiaries meet their medical and social needs related to their diagnosis. Our medical director will also provide input on medical care.

All care coordination activities will be logged so that all Noridian pilot staff can assist providers and beneficiaries with care coordination inquiries.

Noridian staff will be meeting face-to-face with beneficiaries in their homes or other settings to determine individual medical needs and how to best meet these needs, utilizing local physicians and medical professionals. Care coordination also involves the review of claims submitted to the pilot program to determine if pilot benefits are payable, in addition to providing input on the appropriateness of services or treatment before they occur.

Noridian will also be working closely with the Center for Asbestos Related Disease (CARD) staff. The CARD facility is located in Libby and has extensive experience in care coordination for those with an asbestos related disease. They will utilize a multi-disciplinary approach in making recommendations for care required for those with an asbestos related disease. Noridian will work with the CARD facility to create a list of organizations that provide medical care in the Libby area, to which patients can be referred for medical care and services. We will also develop relationships with the providers rendering care for patients enrolled in this pilot program in order to better coordinate care for Medicare beneficiaries.