NUR 514 Discussion Research an organization that uses an innovative model of care
Re: Topic 5 DQ 1
Accountable Care Organizations (ACOs) are organizations that voluntarily satisfy cost and quality goals in exchange for a share of the savings associated with a specific patient group (Highfill & Ozcan, 2016). Medicare beneficiaries are included in this category. Hospitalist Medicine Physicians of California – Apple Valley is a Bundled Payments for Care Improvement Advanced (BPCI-Advanced) Accountable Care Organization. This is an optional payment model designed to reward healthcare providers who invest in practice innovation in order to improve care coordination, cost containment, and quality of care for Medicare beneficiaries (CMS, 2021). By bundling payments for physicians, hospitals, and other healthcare providers, this bundled payment technique prioritizes patients by promoting affordability and increasing access to treatment (CMS, 2021). To monitor program adherence and progress, quality measures such as the administrative quality measure set are in place.
This set covers readmissions for any reason, advance care plans, and patient safety indicators from the Centers for Medicaid and Medicare Services (CMS, 2021). This model has an effect on interprofessional collaboration by rewarding clinicians who collaborate to accomplish goals that promote improved care coordination, efficient service delivery, and high-quality care (CMS, 2021). ACO models, like as the BPCI-Advance, have been found to be more efficient and successful at providing high-quality care at a lower cost than other care models (Highfill & Ozcan, 2016). When organizations, physicians, and other health care providers offer more creative payment structures and quality measurement models to Medicare beneficiaries, not only does healthcare become more inexpensive, but patient happiness increases as well.
CMS. (2021, May 4). BPCI Advanced. Retrieved from Centers for Medicare & Medicaid Services: https://innovation.cms.gov/innovation-models/bpci-advanced
Highfill, T., & Ozcan. (2016). Productivity and quality of hospitals that joined the Medicare Shared Savings Accountable Care Organization Program. International Journal of Healthcare Management, 210-217.
Re: Topic 5 DQ 1
The Mayo Clinic remains one of the more innovative models of care to date. In response to the rapidly changing healthcare scene, the
Mayo Clinic launched their Mayo Clinic Care Network (MCCN) in 2011 (Wald et al., 2018) and it has only continued to grow. The Mayo Clinic is considered innovative due to their formal and widespread use of collaboration that spans continents (Wald et al., 2018). As of 2017, the MCCN had 45 partners, spanning across 35 US states and including the Philippines, Mexico, Puerto Rico, Singapore, and the United Arab Emirates (Wald et al., 2018). International locations is not what makes the MCCN innovative, however. It is considered innovative because providers and healthcare teams can collaborate globally on a case, enabling an MCCN physician to utilize their best resources anywhere in the world. Providers can eConsult an expert for a case without that expert having to physically relocate or force the patient to seek care elsewhere (Wald et al., 2018). Providers can also participate in eBoards, where experts from across the MCCN come together to discuss particular cases on a larger scale (Wald et al., 2018). The Ask Mayo Expert feature brings Mayo Clinic knowledge right into the hands of the patient via internet, enabling patients to glean trusted information when and where they need it (Wald et al., 2018). By using technology to bring teams and patients together, the cost of travel alone is nearly reduced to zero. All of these pieces come together to form a large network of highly collaborative experts with mobilized resources, thus furthering the ability to provide state of the art care when and where the patient needs it most.
Wald, J. T., Lowery-Schrandt, S., Hayes, D. L., & Kotsenas, A. L. (2018). Mayo Clinic Care Network: a collaborative health care model. Journal of the American College of Radiology, 15(1PB), 167-172. https://www.jacr.org/article/S1546-1440(17)31186-9/pdf
Re: Topic 5 DQ 1
Phoenix Indian Medical Center (PIMC) piloted a perioperative surgical home (POSH) that provides quality, patient-centered surgical care (Powell et al., 2017). PIMC’s clients are American Indians who experience health care disparities. The care provided for surgical patients has been distributed amongst many physicians that produced fragmented care. The POSH intends to promote coordinated, patient-focused, evidence-based care (Powell et al., 2017). The surgical care is coordinated throughout the surgical continuum to discharge and follow-up outpatient care. The POSH improves population health, improves patient experience, and decreases health care costs. This coordination of care produces professional collaboration amongst physicians of varying specialties as needed, nursing, and ancillary personnel (Powell et al., 2017). All members of the team must work together to optimize the patient for surgery to create optimal, beneficial surgical outcomes. The coordination of care alone eliminates unnecessary testing or procedures before surgery. The surgeon-led perioperative surgical home utilizes evidence-based clinical pathways to direct preoperative, intraoperative, and postoperative care to minimize complications and improve recovery to optimal functioning (Powell et al., 2017). Through optimization and minimizing complications, the collaborative team is able to reduce health care costs for surgical procedures. The POSH initiative creates a plan of action on how to create the best possible outcomes for surgical patients while reducing costs. The coordination of care places all disciplines on the same page as to how to care for specific patient populations. PIMC found that the model was able to provide the intended results. Additionally, the hospital was able to expand its services in relation to how well the patients recovered from surgery by following the clinical pathways.
Powell, A. C., Thearle, M. S., Cusick, M., Sanderson, D., Van Lew, H., Lee, C., & Kieran, J. A. (2017). Early results of a surgeon-led, perioperative surgical home. Journal of Surgical Research, 211, 154–162. https://doi.org/10.1016/j.jss.2016.12.011
Re: Topic 5 DQ 1
Envision Healthcare has a program called evolution Health that focuses on building a better home care experience for their patients who have recently been discharged from a hospital. According to Evolution Health’s mission statement they “focus on hiring compassionate, highly experienced clinicians and empowering them with evidence-based clinical protocols, we deliver better outcomes, fewer re-hospitalizations and higher patient satisfaction” (Evolution Health, 2020). This organization prides themselves on delivering the highest care to their patients in a home care setting through collaboration from hospitals and the patients’ primary care providers. Through this collaboration, patients are able to have decreased 30-day re-admission rates among high-risk Medicare patients (Roepers et al, 2017). This innovative model affects interprofessional collaboration because all members of the team work together for the benefit of the patients. This organization has a medical command center (MCC) and a mobile integrated team (MIT) that are both available 24/7 for coordinating resources and managing the health of the patient. The ability to treat and manage patients through telemedicine can decrease the overall cost of patients’ long-term admissions and potentially re-admissions for more complex recurrent medical issues.
Evolution Health (2020). Retrieved from https://www.evhc.net/vision/evolution-health
Roeper, B., Beck, E., Castillo, D., Myers, B., Sparkman, B., Cox, J., & Bourn, S. (2017). Innovative Care Model to Improve Clinical Quality and Safety of Transitional Care: Early Outcomes. Managed Care. Retrieved from https://www.managedcaremag.com/system/files/storypdfs/mc_1706_transitional_care_0.pdf
|6 (6%) – 6 (6%)
Communication is professional and respectful to colleagues.
Response to faculty questions are fully answered, if posed.
Provides clear, concise opinions and ideas that are supported by two or more credible sources.
Response is effectively written in standard, edited English.
|5 (5%) – 5 (5%)
Communication is mostly professional and respectful to colleagues.
Response to faculty questions are mostly answered, if posed.
Provides opinions and ideas that are supported by few credible sources.
Response is written in standard, edited English.
|4 (4%) – 4 (4%)
Response posed in the Discussion may lack effective professional communication.
Response to faculty questions are somewhat answered, if posed.
Few or no credible sources are cited.
|0 (0%) – 3 (3%)
Responses posted in the Discussion lack effective communication.
Response to faculty questions are missing.
No credible sources are cited.