Skip to main content
SpringerLink
Log in

New Models of Healthcare Delivery

  • Chapter
  • First Online:
Value Driven Healthcare and Geriatric Medicine

Abstract

The United States is in the midst of a bold experiment. The transformation of the healthcare system has stimulated numerous alternative payment models and many new models of care. There is an array of new healthcare delivery models with varying scope and magnitude of risk for providers. Quality metrics are the outcome measures by which these new models are evaluated.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 59.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 79.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Agency for Healthcare Research and Quality. 2006. The high concentration of US healthcare expenditures. Pub 06–0060. https://meps.ahrq.gov/data_files/publications/st455/stat455.pdf. Accessed 17 Nov 2017.

  2. National Academy of Medicine. Effective care for high need patients: opportunities for improving outcomes, value, and health. Chapters 2, 3. https://nam.edu/initiatives/clinician-resilience-and-well-being/effective-care-for-high-need-patients/. Accessed 17 Nov 2017.

  3. Dzau VJ, McClellan MB, McGinnis J, et al. Vital directions for health and health care: priorities from a national academy of medicine initiative. JAMA. 2017;317(14):1461–70.

    Article  Google Scholar 

  4. Hayes, S. L., C. A. Salzberg, D. McCarthy, D. C. Radley, M. K. Abrams, T. Shah, and G. F. Anderson. 2016. High-need, high-cost patients: who are they and how do they use health care? New York: The Commonwealth Fund. http://www.commonwealthfund.org/publications/issue-briefs/2016/dec/high-need-patients-experience-health-care. Accessed 17 Nov 2017.

  5. Blumenthal D, Anderson G, Burke S, Fulmer T, Jha AK, and Long P. 2016. Tailoring complex-care management, coordination, and integration for high-need, high-cost patients: a vital direction for health and health care. In Discussion paper, edited by National Academy of Medicine. Washington, DC.

    Google Scholar 

  6. Dummit LA, Kahvecioglu D, Marrufo G, Rajkumar R, Marchall J, Tan E, Press MJ, Flood S, Muldoon L, Gu Q, Hassol A, Dott DM, Bassano A, Conway PH. Association between hospital participation in a Medicare bundled payments initiative and payment and quality outcomes for lower extremity joint replacement episodes. JAMA. 2016;316(12):1267–78.

    Article  Google Scholar 

  7. Joynt-Maddox KE, Orav EJ, Zheng J, Epstein AM. Participation and dropout in the bundled payments for care improvement initiative. JAMA. 2018;319:191–3.

    Article  Google Scholar 

  8. http://healthaffairs.org/blog/2016/04/21/accountable-care-organizations-in-2016-private-and-public-sector-growth-and-dispersion/. Accessed 17 Nov 2017.

  9. Centers for Medicare and Medicaid Services. Delivering Better Care at Lower Cost 9/16/14. https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-09-16-2.html?DLPage=6&DLEntries=10&DLSort=0&DLSortDir=ascending. Accessed 17 Nov 2017.

  10. Colla CH, Fisher ES. Moving forward with accountable care organizations: some answers, more questions. JAMA Intern Med. 2017;177:527–8.

    Article  Google Scholar 

  11. Boult C, Wieland GD. Comprehensive primary care for older patients with multiple chronic conditions: "nobody rushes you through.". JAMA. 2010;304:1936–43.

    Article  CAS  Google Scholar 

  12. Hirth V, Baskins J, Dever-Bumba M. Program of all-inclusive care (PACE): past, present, and future. J Am Med Dir Assoc. 2009;10:155–60.

    Article  Google Scholar 

  13. Lynch M, Hernandez M, Estes C. PACE: has it changed the chronic care paradigm? Soc Work Public Health. 2008;23:3–24.

    Article  Google Scholar 

  14. Massachusetts general physicians organization integrated care management program. http://www.massgeneral.org/integrated-care-management/. Accessed 17 Nov 2017.

  15. Bradway CR, Trotta MB, Bixby E, McPartland MC, Wollman H, Kapustka K, McCauley K, Naylor MD. A qualitative analysis of an advanced practice nurse-directed transitional care model intervention. Gerontologist. 2012;52:394–407.

    Article  Google Scholar 

  16. Hirschman KB, Shaid E, McCauley K, Pauly MV, Naylor MD. Continuity of care: the transitional care model. Online J Issues Nurs. 2015;20:1.

    PubMed  Google Scholar 

  17. Naylor MD. A decade of transitional care research with vulnerable elders. J Cardiovasc Nurs. 2000;14:1–14. quiz 88-19.

    Article  CAS  Google Scholar 

  18. Callahan CM, Kroenke K, Counsell SR, Hendrie HC, Perkins AJ, Katon W, Noel PH, Harpole L, Hunkeler EM, Unutzer J. Treatment of depression improves physical functioning in older adults. J Am Geriatr Soc. 2005;53:367–73.

    Article  Google Scholar 

  19. Lin EH, Katon W, Von Korff M, Tang L, Williams JW, Kroenke K, Hunkeler E, Harpole L, Hegel M, Arean P, Hoffing M, Della Penna R, Langston C, Unutzer J. Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial. JAMA. 2003;290:2428–9.

    Article  CAS  Google Scholar 

  20. Unutzer J, Katon W, Callahan CM, Williams JW, Hunkeler E, Harpole L, Hoffing M, Della Penna RD, Noel PH, Lin EH, Arean PA, Hegel MT, Tang L, Belin TR, Oishi S, Langston C. Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial. JAMA. 2002;288:2836–45.

    Article  Google Scholar 

  21. Unutzer J, Katon WJ, Fan MY, Schoenbaum MC, Lin EC, Della Penna RD, Powers D. Long-term cost effects of collaborative care for late-life depression. Am J Manag Care. 2008;14:95–100.

    PubMed  PubMed Central  Google Scholar 

  22. Van Leeuwen Williams E, Unutzer J, Lee S, Noel PH. Collaborative depression care for the old-old: findings from the impact trial. Am J Geriatr Psychiatr. 2009;17:1040–9.

    Article  Google Scholar 

  23. Counsell SR, Callahan CM, Tu W, Stump TE, Arling GW. Cost analysis of the geriatric resources for assessment and care of elders care management intervention. J Am Geriatr Soc. 2009;57:1420–6.

    Article  Google Scholar 

  24. National PACE Association. PACE facts and trends. http://www.npaonline.org/policy-and-advocacy/pace-facts-and-trends-0. Accessed 17 Nov 2017.

  25. Mason DJ. Long–term care: investigating in models at work. JAMA. 2017;318:1529–30.

    Article  Google Scholar 

  26. Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Schwartz JS. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. J Am Geriatr Soc. 2004;52:675–84.

    Article  Google Scholar 

  27. Coleman EA, Smith JD, Frank JC, Min S, Parry C, Kramer AM. Preparing patients and caregivers to participate in care delivered across settings: the care transitions intervention. J Am Geriatr Soc. 2004;42:1817–25.

    Article  Google Scholar 

  28. Mor V, Intrator O, Ferg Z, Grabowski DC. The revolving door of hospitalization from skilled nursing facilities. Health Aff. 2010;29:57–64.

    Article  Google Scholar 

  29. Ouslander J, Lamb G, Tappan R, et al. Interventions to reduce hospitalizations from nursing homes: evaluation of the INTERACT II collaborative quality improvement project. J Am Geriatr Soc. 2011;59:745–53.

    Article  Google Scholar 

  30. Vasilevskis EE, Ouslander JG, Mixon AS, Bell SP, Jacobsen JM, Saraf AA, Markley D, Sponsler KC, Shutes J, Long EA, Kripalani S, Simmons SF, Schnelle JF. Potentially avoidable readmissions of patients discharged to post-acute care: perspectives of hospital and skilled nursing facility staff. J Am Ger Soc. 2017;65:269–76.

    Article  Google Scholar 

  31. Black BS, Johnston D, Rabins PV, Morrison A, Lyketsos C, Samus QM. Unmet needs of community-residing persons with dementia and their informal caregivers: findings from the maximizing independence at home study. J Am Geriatr Soc. 2013;61:2087–95.

    Article  Google Scholar 

  32. Johnston D, Samus QM, Morrison A, JLeoutsakos JS, Hicks K, Handel S, Rye R, Robbins B, Rabins PV, Lyketsos CG, Black BS. Identification of community-residing individuals with dementia and their unmet needs for care. Int J Geriatr Psychiatry. 2011;26:292–8.

    Article  CAS  Google Scholar 

  33. Samus QM, Johnston D, Black BS, Hess E, Lyman C, Vavilikolanu A, Pollutra J, Leoutsakos KM, LGitlin LN, PRabins PV, Lyketsos CG. A multidimensional home-based care coordination intervention for elders with memory disorders: the maximizing independence at home (MIND) pilot randomized trial. Am J Geriatr Psychiatr. 2014;22:398–414.

    Article  Google Scholar 

  34. Tanner JA, Black BS, Johnston D, Hess E, Leoutsakos JM, Gitlin LN, Rabins PV, Lyketsos CG, Samus QM. A randomized controlled trial of a community-based dementia care coordination intervention: effects of mind at home on caregiver outcomes. Am J Geriatr Psychiatr. 2015;23:391–402.

    Article  Google Scholar 

  35. Boltz M, Capezuti E, Bowar-Ferres S, et al. Changes in the geriatric care environment associated with NICHE (nurses improving Care for Health System Elders). Geriatr Nurs. 2008;29:176–85.

    Article  Google Scholar 

  36. Leff B, Burton L, Mader SL, et al. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med. 2005;143:798–808.

    Article  Google Scholar 

  37. Branowicki PM, Vessey JA, Graham DA, McCabe MA, Clapp AL, Blaine K, OʼNeill MR, Gouthro JA, Snydeman CK, Kline NE, Chiang VW, Cannon C, Berry JG. Meta-analysis of clinical trials that evaluate the effectiveness of hospital-initiated post discharge interventions on hospital readmission. J Healthc Qual. 2017;39(6):354–66. https://doi.org/10.1097/JHQ.0000000000000057.

    Article  PubMed  Google Scholar 

  38. Fox MT, Sidani S, Persaud M, Tregunno D, Maimets I, Brooks D, O'Brien K. Acute care for elders components of acute geriatric unit care: systematic descriptive review. J Am Geriatr Soc. 2013;61:939–46.

    Article  Google Scholar 

  39. Ronneikko JK, Makela M, Jamsen EA, Huntala H, Finne-Soveri H, Noro A, Valvanne JN. Predictors for unplanned hospitalization of new homecare clients. J Am Ger Soc. 2017;65:407–14.

    Article  Google Scholar 

  40. Dean KB, Hatfield LA, Jena AB, Cristman D, Flair M, Kator K, Nudd G, Grabowski DC. Preliminary data on a care coordination program for home care recipients. J Am Geriatr Soc. 2016;64:1900–3.

    Article  Google Scholar 

  41. www.nursinghomequalitycampaign.org. Accessed 17 Nov 2017.

  42. Rosland AM, Nelson K, Sun H, Dolan ED, Maynard C, Bryson C, Stark R, Shear JM, Kerr E, Fihn SD, Schectman G. The patient-centered medical home in the Veterans Health Administration. Am J Manag Care. 2013;19(7):e263–72.

    PubMed  Google Scholar 

  43. Moore AB, Krupp JE, Dufour AB, et al. Improving transitions to postacute care for elderly patients using a novel video–conferencing program: ECHO–care transitions. Am J Med. 2017;130:1199–204.

    Article  Google Scholar 

  44. Rand Corporation. The evolving role of emergency departments in the United States, 2013. https://www.rand.org/content/dam/rand/pubs/research_reports/RR200/RR280/RAND_RR280.pdf. Accessed 17 Nov 2017.

  45. Stevens M, Hastings SN, Markland A, Hwang U, Hung W, Vandenberg A, Bryan W, Cross D, Powers JS, McGwin G, Fattouh N, Ho W, Clevenger C, Vaughan C. Enhancing quality of provider practices for older adults in the emergency department (EQUiPPED). J Am Geriatr Soc. 2017;65(7):1609–14. https://doi.org/10.1111/jgs.14890.

    Article  PubMed  Google Scholar 

  46. Camden Coalition. http://healthcarehotspotting.com/wp/introduction/. Accessed 17 Nov 2017.

  47. Sinhal SL. Living longer living well. Report to Ministry of Health and Long Term Care. 2012. http://www.health.gov.on.ca/en/common/ministry/publications/reports/seniors_strategy/. Accessed 17 Nov 2017.

  48. Sinhal SL. (unpublished data) from Insights gained from the development of a community paramedicine program in Canada. Abstract presented at the 21st World Congress of Geriatrics and Gerontology, 2017. p. 49. https://academic.oup.com/DocumentLibrary/GERONI/01_GERONI_igx004.pdf. Accessed 17 Nov 2017.

Download references

Author information

Authors and Affiliations

  1. Vanderbilt University School of Medicine, Tennessee Valley Healthcare System, Geriatric Research Education and Clinical Center, Nashville, TN, USA

    James S. Powers MD

Authors
  1. James S. Powers MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Powers, J.S. (2018). New Models of Healthcare Delivery. In: Value Driven Healthcare and Geriatric Medicine. Springer, Cham. https://doi.org/10.1007/978-3-319-77057-4_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-77057-4_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-77056-7

  • Online ISBN: 978-3-319-77057-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation