For the chronically ill, care delivered in the home is a lifeline to the self-management of chronic conditions. Currently, 90% of Americans age 75 and older have at least one chronic medical condition, and 20% have five or more chronic illnesses (AARP, 2009). The cost of caring for people with five or more chronic illnesses is roughly 17 times higher than for those without chronic illness (Bodenheimer & Berry-Millett, 2009). The complexity of the health care system makes it nearly impossible for patients and families to understand how various services work together, identify what legitimate and feasible demands can be made of providers, and learn how to obtain medical information in a timely and efficient manner (Anderson & Horvath, 2004; Smith, Saunders, Stuckhardt, & McGinnis, 2012). Care coordination is increasingly seen as a way to help patients, families, or other support networks manage medical conditions, and social and psychological problems more effectively (Yang & Meiners, 2014). The impact of care coordination on utilization and cost outcomes in older adults living in the community and receiving long-term nurse care coordination through Aging in Place (AIP) or routine care through home health care (HHC) is reported.
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