Frontiers of Health Services Management - Summer 2013 - (Page 22)
home care presence. three years ago, we
brought our home care services under
a single operating entity with common
management and a common focus. this
shift helped drive home the concept of
care integration so that we now can offer a
regional organized system of care in most
of our markets. Home care is a vital element in our care delivery model. the key
is integrating all of our care coordinating
capabilities, including home care, into the
primary care office.
recognizing that
We define value as the best
chronic disease patients
clinical outcome combined most likely present with
multiple comorbidities, we
with the best patient
experience at an affordable established the advanced
Medical team (aMt)
price. We want the patient program in six of our eight
to see the value that care regions to help physicians
manage these complex
coordination brings.
cases. led by care navigators, the teams work with the referring
physicians, home care services, and community resources to deliver appropriate
care in less acute settings than the emergency department (eD). the aMt program focused initially on treating patients
suffering from chronic obstructive pulmonary disease, congestive heart failure, and
the aftermath of heart attack. now that the
program is being advanced and refined, it
is focusing on all chronic disease conditions. from scheduling regular appointments with patients’ primary care physicians to helping patients comply with their
discharge instructions to arranging transportation for patients to keep doctor and
therapy appointments, the care navigators
help patients live healthier lives and avoid
hospitalization or trips to the eD.
Some regions have also launched coordination projects to reduce nonemergency
visits to eDs. the consistent care program
at UnityPoint Health–St. luke’s Hospital in
cedar rapids, iowa, for example, targeted
103 frequent eD users and worked with
them individually to help them obtain care
from primary care physicians and even set
up their initial appointments. in the first
year of the program, those patients’ visits
to the eD declined by 68 percent (from
1,377 visits during the first nine months of
2011 to 438 visits during the same period
in 2012). the coordination among the St.
luke’s team, primary care physicians, and
community support organizations also is
delivering significant savings in healthcare
costs—$971,246 during the periods studied. today, 233 patients are participating in
the program.
With these inroads, the care coordinating capabilities began to come together to
create value. We have begun to integrate
this capability into our physician offices
and patient-centered medical homes. one
example is the integration of our call center capabilities. We maintain a call center
in Sioux city, iowa, known as My nurse,
that is becoming the first line of triage for
our physician offices. When the system
is completed, a patient will be able to call
My nurse at any time, including after
physicians’ office hours, when those calls
are routed to My nurse. the nurse who
answers the call will be able to identify the
caller as a patient of a particular physician
and have access to the patient’s electronic
health record. the nurse can then triage the patient by phone and determine
whether the patient needs to be seen immediately, how to manage the problem at
home if appropriate, and so on. the nurse
also will have access to the physician’s
schedule and can book an appointment or
request a prescription refill.
22 • f ro ntier s o f h ea lth s e r vic e s ma na g e m e nt 29 :4
Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2013
Frontiers of Health Services Management - Summer 2013
Contents
Editorial
At the Heart of Integration: Aligning Physicians and Administrators to Create New Value
Volume to Value
Physician-Led Models of Accountability and Value: Observations on Payment Policy and Culture
Collaboration Across Clinical Silos
Breaking Down Clinical Silos in Healthcare
Frontiers of Health Services Management - Summer 2013
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