Frontiers of Health Services Management - Summer 2014 - (Page 33)

Conclusion community needs, its quality endeavors, and its initial work in population health through its nascent aco efforts, we are mindful of the continuing challenges, in an ever-changing environment, that we all face as patients, providers, and participants in a complex economy. as described in this article, our focus on governance, building a scalable organizational structure, and engaging a broad range of leaders and stakeholders from the outset have been pivotal to our success. the employee aco has provided UH with a means to further center our medical care around our patients such that we can deliver on this promise through reimagined pathways. By retaining our fundamental commitment to quality and overlaying it with the infrastructure of our acos, we are enhancing the efficiency of medical care provision without diluting its value. Note 1. the project described was supported by funding opportunity number cMS-1c1-12-0001 from the centers for Medicare & Medicaid Services center for Medicare & Medicaid innovation. the contents of this case study are solely the responsibility of the authors and do not necessarily represent the official views of the US Department of Health and Human Services or any of its agencies. Acknowledgment We dedicate this article to our friend achilles Demetriou, MD, PhD, who passed away in 2013 and whose vision was important for the development of our aco. Building on the success UH has achieved in its expansion into and alignment with Thomas F. Z enty III, F A CHE; Er ic J. B ie b e r; a nd E l iz a b e t h R . H a m ma c k * 33 f e a t u r e levels of telephone triage as follows: a nurse can offer triage and advice alone, call in prescription medications for select minor medical problems on the basis of standing orders, or contact a physician for additional evaluation so that no patient is sent for after-hours care without the nurse speaking with a doctor first. the UH rainbow HealthSpot stations are telemedicine kiosks that we are seeking to locate in areas where few after-hours care options other than the eD exist. a remote physician staffs multiple units where patients can go after-hours for care of minor pediatric medical illnesses. the physicians are able to obtain all vital signs and use instruments to visualize the skin, eyes, nose, mouth, and tympanic membranes. a stethoscope at the kiosk allows for respiratory and cardiovascular assessment. Simple lab tests are performed on site while necessary prescriptions are remotely sent to the pharmacy. as part of the effort to establish benchmarks for quality performance in pediatric care, UHrcc is testing novel payment methodologies. it seeks to create sustainability for its programs and to develop new payment arrangements through shared savings agreements with ohio's Medicaid managed care plans. these agreements, as distinct from other agreements UH has in place with commercial payers for aco shared savings, are designed to realize payment on the basis of quality targets aligned with ohio Medicaid's quality targets and improvement in the cost of care for certain programs.

Table of Contents for the Digital Edition of Frontiers of Health Services Management - Summer 2014

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Frontiers of Health Services Management - Summer 2014