The Physician Care Alliance Quality Matrix:
Care Management

The PCA Quality Matrix provides a framework for Care Coordination and Care Management training, tools, and services to assist participating physicians to improve population health, lower costs, and improve the patient experience.

Empowered healthcare teams use these Physician Care Alliance resources to improve the quality of life for patients at risk or living with chronic illness through the management of evidence-based patient centered care. PCA provides training for providers and their healthcare team so that patients receive high quality and effective care in the most appropriate care setting, by the appropriate provider, with a reduction in the total cost of care delivered to the patient.

PCA Care Coordination training and services help provider organizations develop multi-disciplinary and continuum-based programs designed to proactively identify populations with, or at risk for, chronic medical conditions along the continuum of health and wellness. PCA training facilitates patient engagement and targeted population interventions.

PCA Care Management training and services helps providers assist patients with high utilization and uncoordinated areas of care. These clinical areas include chronic illnesses such as congestive heart failure, diabetes and hypertension in addition to other diagnoses including trauma, transplants, or AIDs. By helping provider organizations coordinate services for members with complex conditions, PCA helps patients receive needed resources, regain optimum health, and improve functional capability.

PCA Complex Case Management training and services focus on high risk patients with high utilization of emergency room visits or hospital admissions. Examples of high risk conditions include severe spinal cord injuries and metastatic cancer. Training allows provider teams to identify high risk patients in order to assign the patient to a Nurse Case Manager and/or Certified Case Manager. Staff then works to engage patients to develop and implement a personalized healthcare delivery approach that includes routine follow-up calls, personalized health coaching, specialized condition education, provider communication, and medical service coordination. Integral parts of this training include: patient self-management, self-monitoring activities, medication compliance adherence, and transition to a maintenance phase.