Comprehensive Medical Care for Idaho Medicaid
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St. Luke's Health System President and CEO Dr. David Pate's presentation to at the state of Idaho's Medicaid Managed Care Public Forum held in Boise on Dec. 13, 2011.
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This document discusses the patient-centered medical home (PCMH) model and its benefits. It provides examples of organizations that have implemented PCMH initiatives to improve care coordination, access, costs and outcomes. Key points include:
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Patient Centered Medical home talk at WVU
To employers the cost of healthcare is now a business issue and this talk is about what one large buyer IBM did to drive transformation via broad coalition with other large employers to form the Patient Centered Medical Home movement and the covenant between buyer and provider away from the garbage we now buy episodic uncoordinated disintegrated care. In the change of convenient conversation we have worked with the Primary care providers to give us coordinated, integrated, accessible and compressive care with a set of principles know as the Patient centered medical home.
A Patient Centered Medical Home (PCMH) happens when primary care healers keeping that core healing relationship with their patients step up to become specialists in Family and Community Medicine. The move is to the discipline of leading a team that delivers population health management, patent centered prevention, care that is coordination, comprehensive accessible 24/7 and integrated across a deliver system. PCMH happens when the specialists in Family and Community Medicine wake up every morning and ask the question how will my team improve the health of my community today?
All over the world three huge factors are in play that is driving the concept of Patient Centered Medical Home. They are:
1) Cost and demography
2) Information technology and data (information that is actionable will equal a demand for accountability by the payer or buyer of the care)
3) Consumer demand to engage healthcare differently (at least as well as they can their bank- on line) have a question about lab results why not e-mail?
But at its core it is a move toward integration of a healing relationship in primary care and population management all at the point of care with the tools to do just that.
Social prescription presentation
Social prescribing is an intervention that aims to address patients' non-clinical needs by connecting them with local community services and activities like arts, leisure, learning, or volunteering groups. It has shown positive mental, emotional, and social benefits. The advantages include reduced need for clinical care, increased patient autonomy, and acknowledgment of socioeconomic factors impacting health. The US model incorporates a social prescribing coordinator and volunteers to guide patients to alternative services and support individual needs. UK clinicians agree patients' social needs are as important as medical conditions, and social prescribing could help address unmet resource needs in primary care.
Medical home summit phl 2011
The document discusses the patient-centered medical home (PCMH) model of care delivery. It provides evidence that PCMH is associated with improved outcomes, lower costs, and a better experience of care compared to the traditional fee-for-service model. The document argues that widespread adoption of PCMH is needed to transform healthcare delivery and address issues of cost, quality and access.
How Do Organizations in Healthcare Measure the Value Proposition?
How Do Organizations Measure the Value Proposition? Both the numerator (Quality) and denominator (Cost) must be measured to demonstrate value.
IBM Patient-Centered Medical Home Pre Launch Briefing
The document discusses the patient-centered medical home (PCMH) model for healthcare delivery. It defines key principles of the PCMH model, including having a personal primary care physician, care coordination by an interdisciplinary team, and a focus on comprehensive, high-quality care. The document argues that the PCMH model should be adopted now because the current healthcare system is broken and unsustainable due to rising costs and quality issues. It also outlines how various stakeholders could benefit from the PCMH model through things like improved health outcomes, reduced costs, and enhanced care coordination.
Social prescription presentation
Developing non-clinical approaches and are pathways to fundamental socioeconomic issues that are presented in the primary care and secondary care settings
VBP, Delivery System Reform, and Health and Social Services
This document discusses the transition from fee-for-service to value-based payment models in healthcare. It explains that fee-for-service results in poor outcomes and high costs. Value-based payment ties provider reimbursement to outcomes like quality and cost. The document outlines key components of value-based payment implementation including delivery system reform, payment reform, performance measurement, and population health management. It notes that social services organizations will need to demonstrate their value and be accountable for outcomes as the healthcare system shifts its focus to addressing social determinants of health.
5s-CQI-TQM For Hospital Quality Improvement
5s-CQI-TQM is the approach for improvement of healthcare delivery in a hospital setting, which is resource starved
35NURSING ECONOMIC$January-February 2011Vol. 29No. 1T.docx
35NURSING ECONOMIC$/January-February 2011/Vol. 29/No. 1
T
HE WORLD OF ARISTOTLE AND
Ptolemy believed that Earth
was positioned at the cen-
ter of the universe. Thanks
to Galileo and Copernicus’s studies
in the 16th century, we know this
is not true and that the sun is the
center of our universe. Pers -
pectives of health care have
undergone similar, radical changes
in perception. For centuries we
had a hospital-centric view; an
illness-based model, where the majority of care was
provided in hospitals, when we were ill. In the last
few decades, that model has migrated to a more con-
tinuum of care view; a wellness/health maintenance
model, where emphasis of care is outside the hospital
in other venues such as outpatient, ambulatory/clin-
ic, and home care (see Figure 1).
But as we all know, this is still not where we need
to be to support the highest quality care at the right
cost. Despite a focus on moving care out of the hospi-
tals, one only needs to think about the process of
medication reconciliation between care venues to
realize the lack of seamless integration of care deliv-
ery and the challenges of supporting interoperability
across the continuum. Hence, here I am proposing the
patient centric view, where the patient actively partic-
ipates in his or her care and we look at delivering care
from a patient’s point of view. This allows us to break
down some of the barriers we have struggled with on
our journeys to promote higher quality care through
the use of health information technology (HIT). Now
we need to consider how the health care system
should revolve around the patient, rather than the
patient rotating around the hospital. Considering a
patient-centric point of view when implementing and
optimizing the use of HIT provides new perspectives
on the meaning of “integrated” health care.
Patient-Centric Care
It might seem odd that a health care organization
needs to be reminded to involve the patient in his or
her care. After all, this approach would certainly be
supported from a patient’s perspective. And, of
course, the health care industry has compelling rea-
sons to incorporate a strong customer and service
focus in order to improve patient satisfaction and
impact patient loyalty. But as health care systems
Patient as Center of the Health Care Universe:
A Closer Look at Patient-Centered Care
JUDY MURPHY, RN, FACMI, FHIMSS, is Vice President-
Information Services, Aurora Health Care, Milwaukee, WI; a
HIMSS Board Member; Co-Chair of the Alliance for Nursing
Informatics; a member of the federal HIT Standards Committee;
and is a Nursing Economic$ Editorial Board Member. Comments
and suggestions can be sent to [email protected]
EXECUTIVE SUMMARY
We need to consider how the health care system
should revolve around the patient, rather than the
patient rotating around the hospital.
Considering a patient-centric point of view when
implementing and optimizing the use of health infor-
mation technology (HIT) provides new perspect.
35NURSING ECONOMIC$January-February 2011Vol. 29No. 1T.docx
35NURSING ECONOMIC$/January-February 2011/Vol. 29/No. 1
T
HE WORLD OF ARISTOTLE AND
Ptolemy believed that Earth
was positioned at the cen-
ter of the universe. Thanks
to Galileo and Copernicus’s studies
in the 16th century, we know this
is not true and that the sun is the
center of our universe. Pers -
pectives of health care have
undergone similar, radical changes
in perception. For centuries we
had a hospital-centric view; an
illness-based model, where the majority of care was
provided in hospitals, when we were ill. In the last
few decades, that model has migrated to a more con-
tinuum of care view; a wellness/health maintenance
model, where emphasis of care is outside the hospital
in other venues such as outpatient, ambulatory/clin-
ic, and home care (see Figure 1).
But as we all know, this is still not where we need
to be to support the highest quality care at the right
cost. Despite a focus on moving care out of the hospi-
tals, one only needs to think about the process of
medication reconciliation between care venues to
realize the lack of seamless integration of care deliv-
ery and the challenges of supporting interoperability
across the continuum. Hence, here I am proposing the
patient centric view, where the patient actively partic-
ipates in his or her care and we look at delivering care
from a patient’s point of view. This allows us to break
down some of the barriers we have struggled with on
our journeys to promote higher quality care through
the use of health information technology (HIT). Now
we need to consider how the health care system
should revolve around the patient, rather than the
patient rotating around the hospital. Considering a
patient-centric point of view when implementing and
optimizing the use of HIT provides new perspectives
on the meaning of “integrated” health care.
Patient-Centric Care
It might seem odd that a health care organization
needs to be reminded to involve the patient in his or
her care. After all, this approach would certainly be
supported from a patient’s perspective. And, of
course, the health care industry has compelling rea-
sons to incorporate a strong customer and service
focus in order to improve patient satisfaction and
impact patient loyalty. But as health care systems
Patient as Center of the Health Care Universe:
A Closer Look at Patient-Centered Care
JUDY MURPHY, RN, FACMI, FHIMSS, is Vice President-
Information Services, Aurora Health Care, Milwaukee, WI; a
HIMSS Board Member; Co-Chair of the Alliance for Nursing
Informatics; a member of the federal HIT Standards Committee;
and is a Nursing Economic$ Editorial Board Member. Comments
and suggestions can be sent to [email protected]
EXECUTIVE SUMMARY
We need to consider how the health care system
should revolve around the patient, rather than the
patient rotating around the hospital.
Considering a patient-centric point of view when
implementing and optimizing the use of health infor-
mation technology (HIT) provides new perspect ...
Emotionally intelligent healthcare
The document discusses the need for physician leadership given changes brought by the Affordable Care Act. It argues that physician involvement is critical to successfully implementing programs like Value Based Purchasing and Accountable Care Organizations that encourage quality improvement and cost reduction. However, medical training focuses on clinical skills and does not prepare physicians for leadership roles requiring skills like collaboration and emotional intelligence. Developing physician leadership requires addressing this gap through training that emphasizes competencies like emotional intelligence shown to predict leadership success.
Employer Sponsored Medical Clinics white paper
Employer-sponsored medical clinics have evolved from providing only basic convenience care to playing a larger role in actively managing chronic conditions to help control employers' health care costs. Successful clinics are integrated into the employer's data-driven health strategy and hold the clinic accountable for meeting cost and productivity goals. Different clinic models provide varying levels of services from basic care to full primary care management. For an on-site clinic to be effective, employers need to analyze their claims data to identify conditions driving costs and those amenable to improved management. The Affordable Care Act has prompted some employers to reconsider clinics to help manage costs and improve access to care.
Linking Compensation to Payment Incentives
In an article for Healthcare Executive, Don Seymour, Kevin Talbot, and Chad Stutelberg share their insight on developing compensation strategies that link executive and physician compensation models to acute care outcome-based payment methodologies.
PA Healthcare Forum Insights
The document discusses improving health in communities by aligning incentives to make health profitable. It notes the US healthcare system is strained by chronic conditions exacerbated by an aging population. Experts discuss changing models and behaviors, and how to ensure healthcare reform improves overall community health rather than just preserving existing imbalances. Key ideas discussed include making health states profitable through business models, improving data sharing and transparency, and driving behavioral changes through community efforts.
Performance Evaluations Related to Patient Outcomes: Con
This document discusses pay-for-outcomes based care and its implications for evaluating healthcare providers like nurses. It notes that pay-for-outcomes programs reward hospitals and providers for meeting quality measures and clinical outcomes. However, the document raises several ethical concerns about these programs, including that they could incentivize overtreatment, decrease trust in the patient-provider relationship, and penalize those caring for disadvantaged populations. The document also questions whether it is fair to evaluate nurses based solely on patient outcomes, which can be affected by many external factors outside a nurse's control.
Healing hands care coordination - final, web-ready
This document discusses care coordination models for serving people experiencing homelessness. It provides background on the historical segmentation of health care services and the difficulties this poses for those without stable housing. Care coordination aims to increase access to comprehensive care through coordinated treatment plans, minimizing travel between services by providing multiple services in one location. The document outlines some key elements, goals and benefits of care coordination, as well as ongoing challenges, and provides examples of solutions being implemented through various case studies, including increasing access, improving continuity of care, intensive case management, community outreach, and coordination across settings.
Drhatemelbitar (1)MEDICAL CASE MANAGEMENTد حاتم البيطار
1. The document discusses issues with the current healthcare system including lack of coordination between institutions, dehumanization of care, and rising costs.
2. It introduces case management as a promising solution, defined as a method that aims for continuity of services and quality clinical outcomes through efficient management of available resources for specific clientele.
3. Case management relies on thorough knowledge of client needs, estimating patient stay lengths, and planning coordinated treatment processes to improve care quality while controlling costs.
Similar to Comprehensive Medical Care for Idaho Medicaid (20)
Payment Reform for Primary Care – Minnesota DHS efforts
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How Do Organizations in Healthcare Measure the Value Proposition?
How Do Organizations in Healthcare Measure the Value Proposition?
IBM Patient-Centered Medical Home Pre Launch Briefing
IBM Patient-Centered Medical Home Pre Launch Briefing
VBP, Delivery System Reform, and Health and Social Services
VBP, Delivery System Reform, and Health and Social Services
35NURSING ECONOMIC$January-February 2011Vol. 29No. 1T.docx
35NURSING ECONOMIC$January-February 2011Vol. 29No. 1T.docx
35NURSING ECONOMIC$January-February 2011Vol. 29No. 1T.docx
35NURSING ECONOMIC$January-February 2011Vol. 29No. 1T.docx
Performance Evaluations Related to Patient Outcomes: Con
Performance Evaluations Related to Patient Outcomes: Con
Healing hands care coordination - final, web-ready
Healing hands care coordination - final, web-ready
Drhatemelbitar (1)MEDICAL CASE MANAGEMENTد حاتم البيطار
Drhatemelbitar (1)MEDICAL CASE MANAGEMENTد حاتم البيطار
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Syllabus
Chapter-1
Introduction to objective, scope and outcome the subject
Chapter 2
Introduction: Scope and Specialization of Civil Engineering, Role of civil Engineer in Society, Impact of infrastructural development on economy of country.
Chapter 3
Surveying: Object Principles & Types of Surveying; Site Plans, Plans & Maps; Scales & Unit of different Measurements.
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Chapter 5
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Chapter 6
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1. Palancharmy, Basic Civil Engineering, McGraw Hill publishers.
2. Satheesh Gopi, Basic Civil Engineering, Pearson Publishers.
3. Ketki Rangwala Dalal, Essentials of Civil Engineering, Charotar Publishing House.
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