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Person-Centered Advanced Illness Care Across the Continuum

New care delivery/payment models focus on better care coordination and integration, but few include what most people with advanced illness.

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While there is much talk of “patient-centered care”, the reality is that patients are not at the center of the current health care system. New care delivery and payment models promoted by healthcare reform focus on better care coordination and integration, but few include what most people with advanced illness say are important: their families/caregivers, faith and other communities, and social services. This paper proposes a pathway, the C-TAC Advanced Care Model (ACM), as a framework for stakeholders (including health care providers, plans, and community-based organizations) as they wade through the plethora of new practices, policy options, and payment models for addressing advanced illness in a more holistic and patient-centered way. It will also review experience with Community Action Models that, ultimately combined with the ACM, could extend the care support network well beyond the traditional healthcare system.

What is a provocation or insight that might inspire others during this challenge?

The C-TAC Advanced Care Model (ACM) places the person and their goals, wishes and preference at the center of care delivery, a notion that is not present in many, current care delivery models. It also addresses the psychosocial needs of the seriously ill that are all to often neglected or forgotten about altogether, despite being reported as most important by those facing illness.

Tell us about your work experience:

C-TAC convenes a diverse alliance of patient and consumer advocacy groups, health care professionals and providers, private sector stakeholders, faith-based organizations, and health care payers.

If you participated in an End of Life Storytelling Event, tell us which Chapter or city you came from:




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