By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
    Health
    Healthcare organizations are operating on slimmer profit margins than ever. One report in August showed that they are even lower than the beginning of the…
    Show More
    Top News
    healthcare cybersecurity
    4 Helpful Tips on How to Protect Your Medical Practice Against Cyber Attacks
    October 24, 2021
    Health Check Diagnosis Medical Condition Analysis Concept
    6 Health Woes With Online Remedies
    January 19, 2022
    Eight Things Men Should Know About the Male Menopause
    Eight Things Men Should Know About the Male Menopause
    April 24, 2022
    Latest News
    Beyond Nutrition: Everyday Foods That Support Whole-Body Health
    June 15, 2025
    The Wide-Ranging Benefits of Magnesium Supplements
    June 11, 2025
    The Best Home Remedies for Migraines
    June 5, 2025
    The Hidden Impact Of Stress On Your Body’s Alignment And Balance
    May 22, 2025
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
    Policy and Law
    Get the latest updates about Insurance policies and Laws in the Healthcare industry for different geographical locations.
    Show More
    Top News
    healthy nursing school habits
    Healthy Habits for Nursing Student Nursing School Students
    May 24, 2024
    High Deductables
    High-Deductible Insurance and Rising Bad Debt
    July 24, 2015
    How People Are Taking Advantage of Health Deals in the Recent Recession
    February 5, 2021
    Latest News
    Top HIPAA-Compliant Messaging Apps for Healthcare Teams
    June 25, 2025
    When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
    June 20, 2025
    Preventing Contamination In Healthcare Facilities Starts With Hygiene
    June 15, 2025
    Strengthening Healthcare Systems Through Clinical and Administrative Career Development
    June 13, 2025
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: Coordinated Care Begins With The Patient
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > eHealth > Coordinated Care Begins With The Patient
eHealth

Coordinated Care Begins With The Patient

tkilpatrick
Last updated: June 17, 2014 4:59 pm
tkilpatrick
Share
5 Min Read
Uncoordinated Care
SHARE

Get to know the patient, their needs; then build a care system around them.

Get to know the patient, their needs; then build a care system around them.

Since we cannot separate the disease or clinical condition from the person, coordinated care begins with the patient. Success depends on getting to know them, their clinical conditions, challenges, preferences, passions and goals. For 5% of the United States population that consumes 50% of the healthcare spending “super-utilizers”, getting to know them is critical in patient recovery and generating shared savings.

A study done by the Institute of Medicine estimated the United States could save $271B in 2014 if we reduced uncoordinated care. It would improve lives of people like the 46-year-old female described in the study. She had a cardiac condition, chronic obstructive pulmonary disease and depression. In 12 months of uncoordinated care, she had 185 prescriptions from 34 prescribing physicians and used 21 different pharmacies. She had 395 separate medical events including 45 emergency room visits, 147 outpatient visits and 85 physician visits from 54 different treating physicians.

More Read

Top Rated Mental Health Mobile App Is Only 99 Cents to Honor World Mental Health Day
Leveraging Beacons to Improve Patient Experience
How Online Reviews Are Impacting Your Medical Practice Reputation
Engaging Specialty Practices in the Patient Centered Medical Neighborhood
The Enormous Power Social Media Can Bring to a Hospital

The traditional fee-for-service reimbursement models do not reimburse providers to coordinate care. Managed care health plans and the new performance reimbursement providers offer coordinated care, yet they bear the cost risk of the services while hoping it is offset by shared savings. The options of “no reimbursement” or “full risk” for coordinated care may explain why the 46-year old woman could have 395 separate medical events in a year. Her unmet needs are far beyond the scope of what physicians (the 54 that she saw) are equipped to help with or paid to provide. The result, the same IOM study demonstrated the most extreme uncoordinated care Medicaid patients cost $15,100 compared to $3,116 for those with better coordinated care.

Uncoordinated Care

As we develop the new bundled (Bundled Payments) and global (i.e., Accountable Care Organizations, Patient-Centered Medical Homes) reimbursement models intended to replace traditional fee-for-service, coordinated care approaches need to be developed for “super-utilizers”. The good news is that innovative organizations with global reimbursement models have proven this approach will generate shared savings.  Montefiore, Banner, WellMed, Camden Coalition and Oregon’s Coordinated Care organizations are improving patient outcomes and generating millions of shared savings with comprehensive coordinated care. An Institute of Medicines study on services provided to patients after a hospital stay showed that if we adopted the practices of high performing providers, Medicare cost during this period would drop 73 percent.

What is Coordinated Care?

It’s getting to know the patient and building a virtual private care system around them.

Coordinated Care

Care Decision Making – often requires many tests, opinions and developing viable options for the patient to choose. Each option (i.e., palliative care, cancer treatment) requires understanding diagnosis, prognosis and treatments as well as the patient’s particular social, behavioral and basic needs.

Clinical – addressing Clinical Conditions (chronic conditions, problem lists), Functional Conditions (mobility, self-care ability)

Social & Behavioral – Patient-About (family & friends, stress, career), Lifestyle (activities, roles in lives of others), Behavior (nutrition, social interactions, physical activity), Preferences (change acceptance, Advanced Patient Directives), Patient Activation (understanding conditions, how to take care of them, medication adherence), Technology Adoption (use of mobile devices, blood pressure cuffs, web support groups).

Basic Needs – Socioeconomic Status (food, insurance, money, debt), Physical Environment & Setting (home, security, air conditioning), Access & Logistics (transportation, accessible to services)

Recovery Management – Recovery Team (clinical providers, care givers), Recovery Goals, Recovery Plan (treatments, procedures, other activities), Recovery Monitoring (what?, who?, how?), Recovery Protocols (clinical pathways, event triggers, notification & associated actions).

The findings from innovators like Montefiore ($23M in Shared Savings in first year) and Banner ($13M in Shared Savings in first year) that patient outcomes are tied to addressing “super-utilizers” social, behavioral and basic needs. Patients often place caring for themselves after addressing their unmet needs (i.e., stress, depression, no money for food, clothing or transportation). The success of Coordinated Care (and the new reimbursement models) will be based on determining which patient unmet needs are preventing recovery and then help to address them.

Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

women dental care
What Is a Smile Makeover and How Much Does It Cost?
Dental health
June 30, 2025
HIPAA-Compliant Messaging Apps
Top HIPAA-Compliant Messaging Apps for Healthcare Teams
Global Healthcare Policy & Law Technology
June 25, 2025
recovering from injury
Rebuilding After Injury: Path to Physical and Emotional Recovery
News
June 22, 2025
scientist using microscope
When Healthcare Ends, the Legal Process Begins: What Families Should Know About Probate and Medical Estates
Global Healthcare
June 18, 2025

You Might also Like

social media channels
eHealthSocial Media

10 Great Social Media Channels to Use in HealthCare

October 15, 2013

Young Americans May be Ready for Robotic Medical Assistants

August 16, 2012

HIMSS Meeting Takeaways

March 18, 2011
social media use for medical site
BusinessSocial Media

Beyond the Buzz: Key Trends in Healthcare Social Media

February 6, 2015
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?