Abstract
Integrated care models offer the organizational structure to support the coordination needed to provide high quality care to populations with long-term service and support (LTSS) needs. This study describes how care coordination is operationalized by examining the information exchange processes in several integrated care models. We conducted an environmental scan, convened a technical advisory group, interviewed subject matter experts, and conducted case studies of three integrated care systems. We determined that care coordination and information exchange remain high touch processes, and organizational trust and personal relationships between providers remain foundational to successful care coordination; existing electronic health records are inadequate for integrated care models because they do not capture all information needed to support those with LTSS needs; electronic exchange of information with LTSS providers generally does not occur; and interpretation differences of regulations that protect patient health information create barriers to exchanging information and providing coordinated care.