Advertisement

Moving from Care Coordination to Care Integration

  • Michael K. PokuEmail author
  • Calvin M. Kagan
  • Baligh Yehia
Perspective

It has long been recognized that coordination of health services can improve patient outcomes and experiences, and reduce healthcare costs. Yet, this virtuous goal of aligning and coordinating all care an individual receives has proven to be difficult. Only 7% of healthcare executives, clinical leaders, and clinicians indicated that their patients’ care is fully coordinated across various health settings.1 Care teams are challenged in tracking, sharing, and acting on meaningful health information; communicating with patients, caregivers, and each other; addressing the social determinants of health; and managing care for both patients and populations. With 10,000 Baby Boomers turning 65 years old each day and individuals with multiple chronic diseases on the rise, new approaches to coordination across the care continuum are needed.2

Many health organizations have layered coordinating functions atop disparate clinical programs to support handoffs and transitions. However, this rarely...

KEY WORDS

care integration care coordination care delivery transformation care delivery innovation care integration pillars 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they do not have a conflict of interest.

References

  1. 1.
    Compton-Phillips A, Mohta NS. Care Redesign Survey: Strengthening the Post-Acute Care Connection. NEJM Catalyst. https://catalyst.nejm.org/strengthening-post-acute-care-connection/. Published November 10, 2016. Accessed March 7, 2019.
  2. 2.
    Heimlich R. Baby Boomers Retire. Pew Research Center. December 2010. http://www.pewresearch.org/fact-tank/2010/12/29/baby-boomers-retire/. Accessed March 7, 2019.
  3. 3.
    Brennan BR, Brunisholz KD, Dredge C, et al. Association of integrated team-based care with healthcare quality, utilization and cost. JAMA. 2016;316(8):826–834.  https://doi.org/10.1001/jama.2016.11232,CrossRefGoogle Scholar
  4. 4.
    Hwang W, Chang J, LaClair M, Paz H. Effects of integrated delivery system on cost and quality. Am J Manag Care. 2013;19(5):e175–84.Google Scholar
  5. 5.
    Cohen DJ, Balasubramanian BA, Davis M, Hall J, Gunn R, Stange KC, … Clark K. Understanding care integration from the ground up: Five organizing constructs that shape integrated practices. J Am Board Fam Med. 2015;28(Supplement 1):S7–S20.Google Scholar
  6. 6.
    McGovern M, Dent K, Kessler R. A Unified Model of Behavioral Health Integration in Primary Care. Acad Psychiatry, 2018;42(2):265–268.CrossRefGoogle Scholar
  7. 7.
    Herrel LA, Kaufman SR, Yan P, Miller DC, Schroeck FR, Skolarus TA, … Hollenbeck BK. Health care integration and quality among men with prostate cancer. J Urol. 2017;197(1), 55–60.CrossRefGoogle Scholar
  8. 8.
    Gusmano MK, Thompson FJ. An examination of Medicaid delivery system reform incentive payment initiatives under way in six states. Health Aff. 2015;34(7), 1162–1169.CrossRefGoogle Scholar
  9. 9.
    New York State Department of Health. DSRIP Independent Assessor Mid-Point Assessment Report. https://www.health.ny.gov/health_care/medicaid/redesign/dsrip/pps_map/midpoint/appx_narrative/sbh.pdf. Published November 2017. Accessed March 7, 2019.
  10. 10.
    Allen A. The ‘Frequent Flier’ Program That Grounded a Hospital’s Soaring Costs. Politico Magazine. https://www.politico.com/magazine/story/2017/12/18/parkland-dallas-frequent-flier-hospital-what-works-216108. Published December 18, 2017. Accessed March 7, 2019.
  11. 11.
    University of Maryland Upper Chesapeake Health/ Union Hospital of Cecil County Regional Partnership. Regional Partnership Final Report: Regional Partnership for Health System Transformation. December 2015. https://hscrc.state.md.us/Documents/md-maphs/plan/Regional/UMUCH-UHCC/UMUCH%20-UHCC%20Regional%20Partnership%20Final%20Report%20PackageV2.pdfAccessed March 7, 2010.
  12. 12.
    McConnell KJ, Renfro S, Lindrooth RC, Cohen DJ, Wallace NT, Chernew ME. Oregon’s Medicaid Reform And Transition To Global Budgets Were Associated With Reductions In Expenditures. Health Aff. 2017;36(3):451–459.  https://doi.org/10.1377/hlthaff.2016.CrossRefGoogle Scholar
  13. 13.
    Oregon Health Authority. Oregon Health System Transformation: CCO Metrics 2017 Final Report. June 2018.Google Scholar
  14. 14.
    RTI International. Evaluation of the Maryland All-Payer Model Third Annual Report. March 2018. https://downloads.cms.gov/files/cmmi/md-all-payer-thirdannrpt.pdf. Accessed March 7, 2019.
  15. 15.
    Robert Wood Johnson Foundation and Woodrow Wilson School of Public & International Affairs at Princeton University. Shared Measurement and Joint Accountability Across Health Care and Non-Health Care Sectors: State Opportunities to Address Population Health Goals. January 2017. https://www.shvs.org/wp-content/uploads/2017/01/SHVS-Shared-Measurement-and-Joint-Accountability-Across-Health-Care-and-Non-Health-Care-Sectors-January-2017.pdf. Accessed March 7, 2019.
  16. 16.
    Valentine S. Key Strategies to Build Aligned, High-Performing Physician Networks. March 2018. https://www.healthleadersmedia.com/strategy/key-strategies-build-aligned-high-performing-physician-networks. Accessed March 7, 2019.
  17. 17.
    Brickman J. How to Get Health Care Employees Onboard with Change. Harvard Business Review. November 23, 2016. https://hbr.org/2016/11/how-to-get-health-care-employees-onboard-with-change. Accessed March 7, 2019.
  18. 18.
    Becker’s Healthcare. Shifting Cultures: A Change Management Guide for Hospital Leaders. Becker’s Hospital Review. https://www.beckershospitalreview.com/hospital-management-administration/shifting-cultures-a-change-management-guide-for-hospital-leaders.html. Accessed March 7, 2019.
  19. 19.
    Berry SA, Doll MC, McKinley KE, Casale AS, Bothe A. ProvenCare: quality improvement model for designing highly reliable care in cardiac surgery. BMJ Qual Saf. 2009;18(5), 360–368.CrossRefGoogle Scholar
  20. 20.
    Shay K, Phibbs C, Intrator O, Kinosian B, Scott W, Dally S, Allman R. Evaluation of the costs for veterans receiving care in geriatric medical homes (GeriPACT). Innov Aging. 2017;1(Suppl 1):1329.Google Scholar

Copyright information

© Society of General Internal Medicine 2019

Authors and Affiliations

  • Michael K. Poku
    • 1
    • 2
    Email author
  • Calvin M. Kagan
    • 3
  • Baligh Yehia
    • 4
  1. 1.Methodist Dallas Medical CenterDallasUSA
  2. 2.University of Texas Southwestern Medical CenterDallasUSA
  3. 3.MedStar Georgetown University HospitalWashingtonUSA
  4. 4.Ascension Medical Group, AscensionSt. LouisUSA

Personalised recommendations