The social HMOs. Meeting the challenge of integrated team care coordination.

Four social health maintenance organizations (social HMOs) implemented care coordination programs in 1985 to integrate acute and long-term care for aged Medicare beneficiaries. The team approach to care coordination has been the key concept of the model at all four sites. Team members include the primary care physician, the care coordinator, inpatient and medical office staff, geriatric nurse practitioners, home care nurses and social workers, contracted community-based care staff, and, at three of the sites, volunteers. This article describes how care coordinators work with the health care teams in the social HMOs.