Care management processes
A supportive housing program for late-stage alcoholics who frequently use crisis services features policies that reduce traditional barriers and restrictions to obtaining housing, leading to reductions in alcohol abuse, alcohol-related symptoms, and costs.
A collaborative program leverages information technology to connect ED patients to a medical home and patients receiving care at FQHCs and county health clinics to specialists, leading to enhanced access to care, fewer ED visits, and significant cost savings.
Emergency department–based case managers at nine Milwaukee hospitals use electronic technologies to schedule and track attendance at follow-up clinic appointments for low-income, uninsured patients who come to the emergency department with nonurgent needs, allowing many such patients to establish a medical home.
A practitioner-run, multispecialty center uses various policies, including an independent contracting model, strict credentialing processes, self-governance initiatives, and alternative payment systems, to enhance access to conventional and complementary medical care and improve the health status of underserved patients.
A regional health system with 21 hospitals implemented a comprehensive sepsis care initiative featuring proactive screening in the emergency department, algorithms to guide evidence-based treatment, and tools to support the provision of appropriate care, leading to better diagnosis, more appropriate care, lower mortality rates, and more patients meeting clinical targets.
A large health plan's multifaceted program promotes appropriate prescribing and monitoring of opioid therapy for patients with chronic pain not caused by cancer, leading to enhanced physician knowledge and confidence related to prescribing, greater use of care plans and drug screening, and fewer patients on high-dose therapy.
In combination with training and support for pediatric providers, a large health maintenance organization offered separate parent and teen group meetings in primary care clinics to promote behavior changes in overweight and obese teenage girls, leading to improvements in eating habits, body mass index, and psychosocial outcomes.
A Medicaid managed care plan offers a patient-specific pay-for-performance program tailored to the needs of both large and small practices serving vulnerable populations, leading to improvements in immunization rates and diabetes care.
A large insurer offers financial incentives and other support to provider-led quality improvement collaborations, leading to high levels of provider participation, higher quality, lower costs, and a positive return on investment.
A school district's multifaceted, collaborative initiative to reduce the impact of asthma includes multiple policies and subsequent programs such as electronic monitoring, case management, and stakeholder-specific education, leading to fewer asthma-related absences and better academic performance, behavior, health, and quality of life for students with asthma.