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You are a team of population health management consultants, hired by a large not-for-profit healthcare system. The covered population has a high incidence rate of obesity and diabetes. Based on income, education, and occupation, the community is characterized as being in the middle socio-economic status level. Twenty four percent of this healthcare system's patients are on Medicaid, and 32% are on Medicare. Include approaches addressing gaps in care coordination and effective management of hypertension through a focus on team-based care, patient engagement, and effective use of health information technology tools. Be sure to include in your recommendations' details about the development of a community health promotion program addressing the risks associated with hypertension. Include specific approaches aimed to increase patients' hypertension self-management skills, have patients to adhere to home BP monitoring, ensure patients' understanding of and adherence with medication regimens, and ensure continued patient follow-up and communication with their primary care provider
I've been noticing lately many more "feel good" stories in news, such as the good Samaritans who have turned in backpacks filled with money, or Dairy Queen employee who stood up for his disabled customer
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