Intensive, concurrent medical and behavioral health care, addiction services, and social service coordination improve patient outcomes and reduce health system use among patients who historically have been frequent users of emergency departments.
HealthSpring's Partnership for Quality program offers bonuses to physician practices and onsite care coordination and disease management support, leading to significantly better outcomes and reduced costs for Medicare Advantage enrollees.
A plan-supported medical home model used by clinics serving Medicaid managed care beneficiaries enhances access to care, improves quality, and reduces inpatient admissions.
The American Academy of Pediatrics and four of its state chapters trained and supported pediatric practices on asthma care, leading to better adherence to established guidelines and improved asthma control.
A state-based, public–private partnership supports medical homes in managing the care of Medicaid managed-care enrollees, leading to higher quality and significant reductions in utilization and costs.
A multistakeholder collaborative, the Rochester Blood Pressure Initiative supports the development and implementation of a variety of provider-, employer-, and community-based programs that have collectively improved blood pressure control among hypertensive individuals in metropolitan Rochester, NY.
A county-based accountable care organization integrates medical, behavioral health, and social services and assigns a care coordinator to newly enrolled Medicaid beneficiaries to promote use of appropriate services, leading to fewer readmissions and emergency department visits and lower costs.
Partners in an accountable care organization share risk via an annual global budget and implement initiatives to improve efficiency and quality, leading to reductions in hospital use and overall health care costs.
The Children's Healthcare Access Program offers financial incentives and support services to primary care medical homes serving children covered by Medicaid and their families; the program enhanced access to primary care, increased the percentage of children with asthma action plans, reduced emergency department visits and hospital admissions, increased well-child visits, and reduced costs.
Nurse case managers at a Veterans Affairs hospital provide inhospital and post-discharge, telephone-based support to at-risk, community-dwelling patients and their caregivers, leading to better care transitions, fewer readmissions, and substantial cost savings.