From the May 2017 issue of HealthCare Business News magazine
Models for redesigning care
Recognizing the diverse range of underlying challenges, clinical providers are actively exploring new and innovative care models. A group of Massachusetts hospitals are tackling the challenges associated with care gaps and mental health issues via a grant from the Massachusetts Health Policy Commission’s (HPC) Community Hospital Acceleration, Revitalization and Transformation (CHART) Investment Program.
Among the participating CHART hospitals, one awardee is focused on improving quality of care, increasing efficiencies and reducing costs by addressing gaps in the care continuum with patients that have a combination of intricate social, behavioral and medical needs in the community. The aim is to reduce 30-day readmissions for patients who have a history of excessive emergency department use, as well as additional social complexities such as behavioral health needs.
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A second CHART awardee is focused on transforming the quality, safety and cost of care delivered in the hospital through collaboration with their community-based partners. All efforts are aligned with the Institute for Healthcare Improvement’s (IHI) Triple Aim of improving patient experience, improving population health and reducing the cost of health care. They are working to realize the Triple Aim by enhancing their current health technology and improving behavioral health for at-risk patients. Changes are being made in daily operations to reduce inappropriate use of acute care through evidence-based engagement.
The goal is to reduce cost and lower readmissions, but also increase patient access to the social services necessary to improve the quality of care for high-risk patients. Bundled payment programs bring additional emphasis on the costs associated with readmission rates and the need to redesign care for at-risk patients. In the past, Medicare has paid each provider based on the volume of services they provide to a patient for a given condition or procedure. This has resulted in siloed care and rewarded each provider for the quantity of services provided, not the quality of care provided. With bundled payments, individual providers across care settings have new incentives to collaborate as a network to coordinate efforts to achieve high-quality care, lower readmission rates and lower the overall cost of care.
About the author: Neil Smiley founded Loopback Analytics in 2009 to deliver an advanced Software-as-a-Service platform health care providers can use to prevent costly readmissions. The Loopback Analytics team provides proven intervention solutions that improve clinical outcomes and reduce the total cost of care.Back to HCB News
