Upload File

center for rural health policy analysis the pathway to ...... · patient-centered medical home....

  • Home
  • Documents
  • Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a
51
The Pathway to Health Value October 29, 2014 Spectrum Health Kelsey Hospital Lakeview, Michigan Center for Rural Health Policy Analysis

Upload: others

Post on 03-Aug-2020

1 views

Category:

Documents


0 download

Report

TRANSCRIPT

Page 1: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

The Pathway to Health Value

October 29, 2014Spectrum Health Kelsey Hospital

Lakeview, Michigan

Center for Rural Health Policy Analysis

Page 2: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Outline

• Evolution of Health Care• External Drivers of Change• Adapting for the Future• Rural Health Value TA project

2

Page 3: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

HOW HAS MEDICAL CARE EVOLVED?

Revisiting where we’re coming from

3

Page 4: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Once upon a time, medicine was personal…

• Marcus Welby, M.D.• Physician at the bedside• Lower mobility

– We knew our patients and they knew us

• Technology expectations were not as high

4

Page 5: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

But then we evolved• Specialties• Reimbursement

– Volume over Value

• Technologies• Specialized skills

5

Page 6: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Tyranny of Fee-for-Service

• Current measure of “success” is to maximize:– Office visits per day– Average daily inpatient census– Admissions from the ER

• Is this how you would identify a great physician or a world-class hospital?

6

Page 7: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Australia CanadaFrance

Germany

Japan

NetherlandsNew Zealand

SwedenSwitzerlandUnited States

0

1000

2000

3000

4000

5000

6000

7000

32 33 34 35 36 37 38 39 40 41 42

Per C

apita

Spe

ndin

g

Male Life Expectancy at 40

Spending and Life Expectancy 1976

77

Page 8: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

AustraliaCanada

FranceGermany

ItalyJapan

Netherlands

New Zealand

SwedenSwitzerland

United Kingdom

United States

0

1000

2000

3000

4000

5000

6000

7000

32 33 34 35 36 37 38 39 40 41 42

Per C

apita

Spe

ndin

g

Male Life Expectancy at 40

Spending and Life Expectancy 1986

Adapted from a slide by Sherry Glied, Wagner School, NYU8

8

Page 9: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

AustraliaCanadaFranceGermany

Italy JapanNetherlands

New ZealandSweden

Switzerland

United Kingdom

United States

0

1000

2000

3000

4000

5000

6000

7000

32 33 34 35 36 37 38 39 40 41 42

Per C

apita

Spe

ndin

g

Male Life Expectancy at 40

Spending and Life Expectancy 1996

Adapted from a slide by Sherry Glied, Wagner School, NYU9

9

Page 10: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

AustraliaCanadaFranceGermany

Italy Japan

Netherlands

New Zealand

Sweden

Switzerland

United Kingdom

United States

0

1000

2000

3000

4000

5000

6000

7000

32 33 34 35 36 37 38 39 40 41 42

Per C

apita

Spe

ndin

g

Male Life Expectancy at 40

Spending and Life Expectancy 2006

Adapted from a slide by Sherry Glied, Wagner School, NYU10

10

Page 11: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Spending and Life Expectancy 2011

Australia

Canada

FranceGermany

Italy

Japan

Netherlands

New ZealandSweden

Switzerland

United Kingsom

United States

0

1000

2000

3000

4000

5000

6000

7000

32 33 34 35 36 37 38 39 40 41 42

Per C

apita

Spe

ndin

g

Male Life Expectancy at 40

Modeled after slides by Sherry Glied, Wagner School, NYU11

11

Page 12: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Value Equation

Value = Quality + ExperienceCost

But does our current volume-based payment system impede delivering health care of value?

12

Page 13: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

The Triple Aim (2008)

• A framework developed by the Institute for Healthcare Improvement (IHI) that describes an approach to health system performance

• The three dimensions are:– Improving the patient experience of care (including

quality and satisfaction)– Improving the health of populations– Reducing the per capita cost of health care

13

Page 14: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Unacceptable Healthcare Value• Quality suboptimal

– Deficient when compared internationally– Wide geographic variation

• Cost unsustainable– Growth in excess of GDP growth– Highest cost in the world

• Experience:– Difficult to get appointments– Feeling rushed– Lack of coordination

• Waste intolerable (20%)*– Care delivery, care coordination, overtreatment, administration,

pricing failures, fraud and abuse.

*Source: Berwick and Hackbarth. Eliminating Waste in US Health Care. JAMA, April 11, 2012. Vol. 307, No. 14

14

Page 15: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

We are Headed off of a Cliff• Expenditures for health care are spiraling beyond any single

fix• Complexity of health

care problems presentmore opportunities for medical error

• Millions with limited access because of cost,availability, cultural misfit

• Health care professionals with declining morale• Breakthrough policies that contribute to problems: Medicare

Part D

15

Page 16: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

The Value ConundrumYou can always count on Americans to do

the right thing – after they’ve tried everything else.

• Fee-for-service• Capitation• Market• Single payer• Self-police

What about paying for health care value?• Pay-for-Performance (P4P)?• Accountable Care Organizations

(ACOs)?• Patient-Centered Medical Homes?

16

Page 17: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

THE EXTERNAL DRIVERS OF CHANGE

17

Page 18: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

The Winds of Change• Health care reform• Safety and quality• Aging• Consumerism• Technology• New care delivery

models• Information technology• Community

accountability• Workforce shortages• Declining revenue

18

Page 19: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

A sample of policy and structural changes

• Affordable Care Act• CMS Value-Based Purchasing & other payment

changes• Accountable Care Organizations• Patient-Centered Medical Homes• State Innovation Model Grants• Innovations in delivery

19

Page 20: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Affordable Care Act

• Health care reform predicated on a robust primary care foundation– Workforce provisions– Preventive services focus– Accountable care organizations– Value-based purchasing– Care coordination– Medical homes

20

Page 21: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Value-Based Purchasing & payment changes

• Medicare Payment Changes– Uncertain future (at best) for cost-based

reimbursement, unless through exceptions (FCHIP)

– Demonstrations of new methods, including bundled payment, value-based for Critical Access Hospitals

– Value-based purchasing across provider types– ACOs

21

Page 22: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Accountable Care Organizations• Estimated 14% of U.S. population now being served by an

ACO• 5.3 million in Medicare ACOs• More than 6.5% of the Medicare population• ACOs in rural places

– 109 ACOs operate in a combination of metro and non-metro counties

– 8 ACOs operate exclusively in rural areas, including 1 such ACO in each of the 4 census regions

– 24.4% of non-metropolitan counties include a primary care provider being assigned Medicare patients

Sources: – “The ACO Surprise” by Niyum Gandhi and Richard Weil. Oliver Wyman, Marsh & McLennan Companies. 2012.

http://www.oliverwyman.com/media/OW_ENG_HLS_PUBL_The_ACO_Surprise.pdf.– Centers for Medicare and Medicaid Services Fast Facts as of May, 2013– RUPRI analysis of data obtained from public sources and ACOs

22

http://www.oliverwyman.com/media/OW_ENG_HLS_PUBL_The_ACO_Surprise.pdf
Page 23: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Accountable Community Organizations

• Paradigm shift continues to all payers• Paradigm shift continues to population health• Being discussed now at CMS

23

Page 24: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Patient-Centered Medical Home

Primary care practices that offer around-the-clock access to coordinated care and a team of providers that values patients’ needs• Access and communication• Coordination of care• Patient and family involvement• Clinical information systems• Revised payment systems

Source: Commonwealth Fund. http://www.commonwealthfund.org

24

Page 25: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Person-Centered Health Home

• Another paradigm shift• Focus becomes home based, not clinic based• Incorporates consideration of social

determinants

25

Page 26: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

State Innovation Models• Providing support to

states for the development and testing of state-based models for multi-payer payment and health care delivery system transformation

• Massachusetts supporting:– Practice transformation to

medical homes– Shared risk/savings– Statewide quality metrics

26

Source: http://innovation.cms.gov/initiatives/state-innovations/

http://innovation.cms.gov/initiatives/state-innovations/
Page 27: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Innovations in delivery

• In health care workforce: community paramedics, community health workers, optimal use of all professionals (requires rethinking delivery and payment models – implications for regulatory policy including conditions of participation)

• In use of technology: providing clinical services through local providers linked by telehealth to providers in other places, and providing services directly to patients where they live

27

Page 28: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Moving Along the Path

• CMS: Medicare payment, now 20% through alternative payment methodologies, and rising fast; only 10% with no value component

• Physicians – 9% linked to quality and new $800 million initiative to transform practices

• Next generation of ACOs• State Medicaid programs using new payment

methodologies• Private health plans continue evolving

28

Page 29: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

ADAPTING FOR THE FUTURE

29

Page 30: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Health Care Transformation

• How do we move toward delivering value when our revenue is primarily volume-driven?

• How do we not get “soaked” during the transition?

• We can “test the waters” with a new set of tools

30

Page 31: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Transforming Care in the FacilityToday’s Care

Patient's chief complaint or reasons for visit determines care.

Care is determined by today's problem in time available today

Care varies by scheduled time and memory/skill of doctor.

Patients are responsible for coordinating their own care.

Clinicians know they deliver high quality care because they're well-trained

It is up to the patient tell us what happened to them.

Transformed PracticeWe systematically assess all our patients health needs to plan care.

Care is determined by a proactive plan to meet patient needs.

Care is standardized according to evidence-based guidelines.

A prepared team of professionals coordinates a patient's care.

Clinicians know they deliver high-quality care because they measure itand make rapid changes to improve.

You can track tests consults and follow-up after the ED in hospital.

31

Page 32: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Tracking Populations

Tracks all the quality measures of interest to them for their hypertensive patients comparing the organization, 3 clinics and one provider to the state statistics

32

Page 33: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Transforming Care More Broadly• Inpatient Beds Community care

– Expanded/robust primary care– Workplace nursing and SNF/ALF clinics– Mobile clinics and telehealth

• Illness Wellness– Health Risk Assessments– Community Health Assessments– Health coaching and care coordination

• Charges Costs– Revenue becomes covered lives– Charge master becomes cost master– Re-purpose inpatient space

33

Page 34: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Improving Health

• To improve health, we must move beyond the walls of our health care facilities

• We must collaborate

34

Page 35: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

What are the Determinants of Health?

• County Health Rankings & Roadmaps program– a collaboration between

the Robert Wood Johnson Foundation

– the University of Wisconsin Population Health Institute.

• Much of what influences our health happens outside of the provider’s office

35http://www.countyhealthrankings.org/about-project/rankings-background

35

http://www.rwjf.org/
http://uwphi.pophealth.wisc.edu/
http://www.countyhealthrankings.org/about-project/rankings-background
Page 36: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Another way to look at it

3636

Page 37: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Lessons from the Field

• Address social issues with prescriptions and follow up • Take holistic approach to population health

– Affiliate with organizations who are not healthcare providers

– Truman Medical Center in Kansas City partnered to open grocery store, bank

• Promote price transparency• Include physicians in administrative decision-making• Serious about hospitality

– Patient experience as area of expertise in upper management

37

Page 38: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Lessons from “Progressive Hospitals”

• Partner with employers– Working with local employers on wellness

initiatives, primary and preventive care

• Let patients access personal health information– “Open notes”

Taken from “10 Things the Most Progress Hospitals Do.” Molly Gamble, Beckers Hospital Review. July 8, 2013

38

Page 39: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Elements of a Successful System Redesign

Elements• Clear Vision• Teamwork• Leadership• Customer focus• Data analysis and action plans• Inclusive beyond health care system

Source: Pursuing the Triple Aim, Bisognano and Kenney. Jossey-Bass. 2012

39

Page 40: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Specific Hospital Activities for CAHs

Hospital leadership fully understand and begin to build case for population health management

Hospitals put population health on meeting agendas, including board, management, quality improvement

Hospitals look within own walls and initiate employee wellness programs

Hospitals reach out to communities to discover health program wants and needs

Source: National Rural Health Resource Center (2014) Critical Access Hospital Population Health Summit: Improving Population Health: A Guide for Critical Access Hospitals

Page 41: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Lessons from Hospitals in Healthiest Counties

Dansville, NY: “change from thinking about the care that is given while the patient is within our walls to thinking about the care of the patient outside our walls”Dansville: “We no longer see ourselves as a

standalone organization, but rather as part of the region’s broader healthcare ecosystem”

Page 42: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Lessons from Hospitals in Healthiest Counties

Oakland CA: “just as our focus on total health–integration, prevention, and empowerment–drives internal planning for our members, it also drives planning for improving the health of our community”

Oakland CA: “we work closely with the county and state public health departments, reviewing various sets of data, including mortality and morbidity data, as well as substance abuse, drinking, and tobacco consumption figures”

Page 43: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Lessons from Hospitals in Healthiest Counties

Raleigh, NC: “a physician-led effort in partnership with the hospital to provide integrated, patient-centered care. This means coordination of care, more involvement in prevention as well as a more active role in helping people manager their overall health outside of the healthcare setting.”

Source: Rizzo E (2014) Population Health Lessons From Hospitals in the U.S.’ Healthiest Counties: 3 CEOs Share Successes. Becker’s Hospital Review. June 2.

Page 44: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Examples From Rural Institutions• Available from the Rural Health Value project:

http://cph.uiowa.edu/ruralhealthvalue/innovations/Profiles/

• Community Outreach in Delhi, LA• System Transformation in the Mercy Health

Network, IA• Service Delivery Integration& Patient

Engagement in Humboldt County, CA

http://cph.uiowa.edu/ruralhealthvalue/innovations/Profiles/
Page 45: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Other InnovationsChief Medical Financial Officer in Banner

General Hospital in Sandpoint, Idaho (CAH)Chief Patient Experience Officer named at

Johns Hopkins MedicineAll about value for the patient/customer

Page 46: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

RURAL HEALTH VALUETechnical Assistance Project

46

Page 47: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Rural Health Value: Facilitating Rural Health Transformation

Three-year HRSA Cooperative agreement: Rural Health System Analysis and Technical Assistance (RHSATA)

Partners: RUPRI Center for Rural Health Policy Analysis and Stratis Health, with support from Stroudwater Associates and Washington University in St. Louis

Vision: To build a knowledge base through research, practice, and collaboration that helps create high performance rural health systems

47

Page 48: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Rural Health Value Project Aims1. Analyze rural implications of health care delivery,

organization, and finance changes fostered by public policy and private sector actions

2. Develop and test technical assistance tools and resources to enable rural providers and communities to take full advantage of public policy changes and private sector initiatives

3. Inform further developments in public policy and private action through dissemination of findings

48

Page 49: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Reflection and Insight• There is no off-the-shelf solution• It’s about long term capacity, not program of the

day• Small numbers can be challenging, so get creative

in measurement• Find and create a peer network• Lessons learned from rural innovators:Create a climate of necessityIdentify resources and funds to support and sustain

changeFind the innovators in the community – people “that

make things happen”

49

Page 50: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

In Conclusion

• Change is coming, do not get left behind

• Work within your walls to improve care

• Work with your community to improve health

• We are here to help you get started

50

Page 51: Center for Rural Health Policy Analysis The Pathway to ...... · Patient-Centered Medical Home. Primary care practices that offer around-the-clock access to coordinated care and a

Questions?For more information about Rural Health Value, contact:

Rural Health System Analysis and Technical AssistanceUniversity of Iowa | College of Public Health

Department of Health Management and PolicyWeb: http://www.RuralHealthValue.orgE-mail: [email protected]

Phone: (319) 384-3831

Center for Rural Health Policy Analysis


Patient Centered Primary Care Homes and Coordinated Care

Children’s Medical Services “101”zFamily-centered, comprehensive, coordinated statewide managed system of care that links community-based health care with multidisciplinary,

Medical Home & Coordinated Care

VALUE-BASED PURCHASING L COLLABORATIVE … More Coordinated, Person-Centered Care . ... •The Value-Based Purchasing MAC Collaborative: A ... mental health, and chemicalPublished

Advocate’s Guide to California’s Coordinated Care initiative · Advocate’s Guide to California’s Coordinated Care initiative AdvocAte’s Guide to cAliforniA’s coordinAted

Health IT and Health Care Delivery and Payment …...Payment and delivery reform models •PCMH –Patient-Centered Medical Home –Care delivery model with patient care coordinated

Person centered care

BCBSM Physician Group Incentive Program...The Patient-Centered Medical Home (PCMH) is a care delivery model in which patient treatment is coordinated through primary care physicians

California’s Coordinated Care Initiative Pharmacist’s Role in the Coordinated Care Initiative June 2014

Providing Coordinated Care

NCQA Patient-Centered Medical Home (PCMH) · A patient-centered medical home (PCMH) is a care delivery model in which patient treatment is coordinated through the primary care physician

Family Centered Care- Promoting Successful Partnershipsdepts.washington.edu/lend/pdfs/8-10-15_Carlsen_Familycenteredcare... · What is Family Centered Care? Family centered care in

Two Studies of Family-Centered Care Family-Centered Care

Heart-centered Care

Care. Centered. 4o - hascares.org. Forty Years of Coordinated Care. 1. Leadership. ... Marco Jacome Adnan Assad Chief Executive Officer Board President. Adnan Assad and Marco

Health Care Transformation & Coordinated Care Organizations

No Man is An Island: The Coordinated Journey to A … - NCQA...No Man is An Island: The Coordinated Journey to A Patient-Centered Healthcare System for Patient-Centered Primary Care

Provider Directory Commonwealth Coordinated Care Plus · Provider Directory . Commonwealth Coordinated Care Plus . ... Provider Directory. Commonwealth Coordinated Care Plus ... 1376541581/010184

Introduction to Palliative and End-of-Life Care in PACE. Intro to... · 2019-12-18 · •Palliative care in PACE is participant and family-centered care coordinated by the IDT which

California’s Coordinated Care Initiative

The Oregon Living Well Business Plan and the Self ... · Health system transformation is happening! –Coordinated Care Organizations –Patient Centered Primary Care Homes –Increased

Nurse Practitioners and Team Based CareTeam Based Care is to provide coordinated, high quality, and patient-centered care.” (IOM—Best Practice Innovation Collaborative, 2012)

Coordinated Care Organizations

FAMILY-CENTERED CARE, PATIENT-CENTERED CARE, AND CULTURALLY COMPETENT ... · family-centered care, patient-centered care, and culturally competent care: common themes and background

Patient centered care

The PTAC Preliminary Review Team’s Questions on Advanced ... · 8/3/2017  · Delivering Patient-Centered, Longitudinal, and Coordinated Care ... patient attribution, payment flow,

PATIENT-CENTERED CARE (QSEN) CARE (QSEN) Definition: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based

Title V: - IN.gov V_CSHCN Domain RFA... · Web viewImplement family-centered, community-based, systems of coordinated care for children with special health care needs. TITLE V transformation

Coordinated System of Care · Coordinated System of Care • • • 1 . Coordinated System of Care. Quality Improvement Strategy . Overview . The Coordinated System of Care is designed

VHA Handbook 1101.11(3) Coordinated Care for Traveling ... · provides procedures for VHA personnel regarding patient-centered coordination of care ... COORDINATED CARE FOR TRAVELING

Person Centered Care - Hospital Quality Institute · What is Person-Centered Care? In 2015, the American Geriatric Society (AGS) defines Person Centered Care as follows: “Person-centered

CHAPTER 265: OUTPATIENT / PACT CLINIC 265: Outpatient / PACT Clinic ... A PACT Primary Care Module utilizes a variety of physical spaces for coordinated, patient-centered care including:

2. The Patient-Centered Medical Home · team-based care, patient-centered orientation toward the whole person, care that is coordinated across all elements of the health care system

Community-wide Coordinated Care

Commonwealth Coordinated Care (CCC) Phase-Out Plan · will have access to an individualized, person‐centered system of care that integrates medical, ...