Health reform is increasing pressure on health providers to find the most effective and cost-efficient models of care to meet the needs of patients. The emerging models of care typically use integrated, team-based approaches to service delivery.
Many of the emerging models of care emphasize better coordination of care provided to patients. Care coordination is characterized by primary care providers and others assuming responsibility for managing the overall care of their patients, both within their practice and with other providers, including behavioral health providers, specialists, and community resources. As a result, new categories of workers are emerging in the health workforce, such as care coordinators, patient navigators, and community health workers. These new roles entail linking all of a patient’s service providers, ensuring effective communication, monitoring service delivery, preventing duplication of services, identifying gaps in care, and assuring better health outcomes, particularly for patients with complex medical or behavioral health needs.
New roles have emerged quickly and there is much overlap between and within job titles. This has created confusion as to what team members’ job functions are. Successful integration of these new roles into team-based models of care will require an understanding of these new roles and the roles of others in care delivery.