Care Coordination Management
Coordination of care across providers, settings, and time including referrals, case management, transitions of care, discharge planning, utilisation management, and social-determinant linkage.
Care Coordination Management (BC-2820) is a level-1 business capability in the Healthcare Providers model. The catalog holds 28 API surface(s) from 15 provider(s) that can perform some part of it, 4 of them rated strong or better. Reach is the vendor surface that lands on this capability — it is not a claim about what any particular organisation has deployed.
Authorities this capability cites
Cited by the capability model itself. These frameworks are referenced, never redistributed, and citing one does not imply its owner endorses this listing.
- https://www.cms.gov/medicare/quality/value-based-programs
- https://www.ncqa.org/programs/health-care-providers-practices/patient-centered-medical-home-pcmh/
- https://www.acmaweb.org/
- https://www.ihi.org/Topics/Transitions-of-Care
Sub-capabilities
Referral Management BC-2820.10
End-to-end management of patient referrals from order capture through specialist match, tracking, and closure.
Case & Care Management BC-2820.20
Identification, planning, and execution of case-management interventions for high-risk and complex patients.
Discharge Planning BC-2820.30
Planning for safe discharge from inpatient care including needs assessment, post-acute placement, and patient education.
Transitions of Care BC-2820.40
Coordination of patient transitions between providers and settings to ensure continuity, safety, and outcome accountability.
Utilisation Management BC-2820.50
Review and oversight of admissions, continued stays, and length of stay against medical necessity and utilisation criteria.
Social Determinants & Community Linkage BC-2820.60
Identification of social determinants of health and linkage to community resources to support clinical outcomes.
Providers that reach this capability
Ordered by rating band. Reach means a provider publishes an API surface that can perform some part of this capability — it is not a claim that any particular organisation has deployed it.
Exemplar 2 Complete, well-documented, and agent-ready
Developing 8 Usable, with meaningful gaps to close
Thin 3 Limited public surface area
Workflows that realise this capability
Arazzo workflows whose own sourceDescriptions call APIs that carry this
capability. The link is derived, not asserted: each workflow declares
x-realizes-capability-ids with the spec and confidence behind it.
- Canvas Medical Care Plan Management
— canvas-medical
· Care Coordination Management
BC-2820