Characteristics of Practice Facilitators and Care Managers
| Role | Core Functions | Connection to Practices and Patients | Educational Background |
|---|---|---|---|
| Practice facilitator | Help the practice organize, prioritize, and sequence QI activities Train practice staff to understand and use data to drive QI Increase practice capacity for QI activities Help build a team orientation among practice staff and a practice culture receptive to change Share best practices and lessons across practices | Facilitator is typically employed by an external organization (not the practice) Facilitator works with practice staff (not patients) Facilitator typically works mostly on site at the practice with some interactions by phone, e-mail, or video conference; some facilitators work entirely virtually | Social work, nursing, counseling, health management, business, and other areas |
| Care manager | Assess the patient’s care needs Develop, reinforce, and monitor individualized care plan Provide patient education and training in self-management skills Coordinate patient’s care with other providers and settings, and communicate needed information Connect patient to community resources and social services Participate in practice QI activities | Care manager may be employed by the practice itself, a payer, or state. They are closely integrated into the practice team Care manager provides services to patients and families Care manager (as we define) works at the practice, and may also interact with patients by telephone, e-mail, in the patient’s home, or in other providers’ offices | Nursing, social work, counseling, and other areas |
QI = quality improvement.