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