Development of a Managed-Care Team in a Traditional Home Healthcare Agency

Increasing numbers of home health clients have managed-care insurance plans. Issues related to the care of these clients in the home are different from those that relate to the care of Medicare clients. The Visiting Nurse Association (VNA) of Northern Virginia developed a managed-care team whose staff is trained to work effectively and efficiently with managed-care companies while maintaining a goal of quality care.The evolution of the managed-care team concept is described and offered as a model for other traditional home health agencies. Critical success factors for implementing a dedicated managed-care team are defined. Speculation about the future of the VNA's managed-care team and the implications for nursing and home healthcare of the managed-care team concept are discussed.