Table 1.

Description of the PDCM and HPDCM Care Management Approaches

Characteristics	PDCM					HPDCM
	PO-A	PO-B	PO-C *	PO-D *	PO-E
Size of practice †	Small to large	Very small to small	Small to very large	Very small to large	Medium to very large	Small to very large
Practice discipline	Family medicine	Family medicine	Family or internal medicine	Family or internal medicine	Family or internal medicine	Family, pediatric or adult
Location of care manager ‡	Centralized and embedded	Centralized	Embedded	Centralized and embedded	Embedded	Centralized
Care management offering mode §	CM via phone	Provider referral to CM; CM via phone	Provider offers during visit; CM sees patients right after; or CM via phone	Provider offers during visit; CM sees patients right after; or CM via phone	Provider offers during visit; CM sees patients right after	CM via phone or recorded message
Care management delivering mode	Phone	Phone	In person at practice and phone	In person at practice and phone	In person at practice and phone	Phone
CM background and training	RN	RN	RN, nurse practitioner or PharmD	RN, licensed practical nurse or medical assistant	RN	RN
Care management activities	Chronic disease education, self-management support, motivational interviewing, goal setting, and health coaching
Focus of efforts	Complex chronic disease; diabetes	Chronic conditions and health promotion (weight loss, smoking cessation)	Chronic conditions; patients with medication management issues	High risk patients based on survey conducted by PO or provider	Complex chronic disease, non-compliant patients	High utilizing members
CMP history and other information	New. CM attends PO learning collaborative meetings	CMP in place prior to pilot; CM functions in quality improvement role; CM has user privileges in EHR	CMP in place by RN; panel member works with PharmD in team approach	New. CM attends PO learning collaborative meetings	CM in place and highly integrated	Ongoing disease management program

PDCM provider-delivered care management, HPDCM health plan-delivered care management, PO provider organization, CM care manager, CMP care management program PharmD doctor of pharmacy, RN registered nurse, EHR electronic health records

* PO-C and PO-D each had two sub-models. They are combined and described together

† Size of practice: very small = single provider; small = two to three providers; medium = four to ten providers; large = 11 to 25 providers; very large = more than 25 providers

‡ For PDCM programs, the centralized location is at the PO and the embedded location is at the practice; for HPDCM programs, the centralized location is at the health plan

§ Programs differ in who initially offers the opportunity of care management to patients, and in what mode (in person or via phone)