Alternative Payment Models and Team-Based Care

Mose, Jason N; Jones, Cheryl B.

doi:10.18043/ncm.79.4.231

Cited by 6 publications

(6 citation statements)

References 9 publications

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“…These teams could include multidisciplinary physicians, APPs, nurses, clinic managers, finance directors, and other relevant staff, similar to the robust program developed by the Parkinson's Foundation. 62 The program should develop skills necessary to implement efficient team-based care, including communication and leadership skills, understanding financial models, 63 innovation, sharing of best practices, and consensus building of all team member roles. 60 Tactic 2c: Widen the Neurologist Pipeline Through surveys of graduating medical students, the AAN Pipeline program has deepened our knowledge related to medical students' choice or elimination of neurology as a field.…”

Section: Tactic 2a: Incorporate Apps Into Neurology Practicesmentioning

confidence: 99%

A Shortage of Neurologists – We Must Act Now

et al. 2021

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In nearly every US state, a large mismatch exists between the need for neurologists and neurologic services and the availability of neurologists to provide these services. Patients with neurologic disorders are rising in prevalence and require access to high-level care to reduce disability. The current neurology mismatch reduces access to care, worsens patient outcomes, and erodes career satisfaction and quality of life for neurologists as they face increasingly insurmountable demands. As a community, we must address this mismatch in the demand and supply of neurologic care in an aggressive and sustained manner to ensure the future health of our patients and our specialty. The American Academy of Neurology has multiple ongoing initiatives to help reduce and resolve the existing mismatch. With the intent of raising awareness and widening the debate nationally, we present a strategic plan that the Academy could implement to coordinate and expand existing efforts. We characterize the suggested strategies as shaping the demand, enhancing the workforce, and advocating for neurologist value. The proposed framework is based on available data and expert opinion when data were lacking. Prioritization of strategies will vary by geography, practice setting, and local resources. The time to act is now to allow concerted effort and targeted interventions to avert this looming public health crisis.

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Section: Tactic 2a: Incorporate Apps Into Neurology Practicesmentioning

confidence: 99%

A Shortage of Neurologists – We Must Act Now

et al. 2021

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“…More recently, however, Medicaid, the United States' public health insurance programme, was expanded to include more eligible individuals. At the same time, alternative payment models emerged, which added incentives for high-quality, cost-effective and coordinated care (Mose & Jones, 2018). Combined, the Medicaid expansion and financial incentives have motivated health systems and health plans to consider the delivery of housing programmes to address the underlying conditions that may influence high healthcare spending (Cantor et al, 2020;Kuehn, 2019;Wilkins, 2015).…”

Section: Introductionmentioning

confidence: 99%

Perceived care coordination among permanent supportive housing participants: Evidence from a managed care plan in the United States

Palimaru

McBain

McDonald

et al. 2021

Health Soc Care Community

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Homelessness is a pervasive public health problem in the United States (U.S.). Under the U.S. Affordable Care Act, the nation's public health insurance program (Medicaid) was expanded to serve more individuals, including those experiencing homelessness.Coupled with changes in financial incentives designed to reduce healthcare costs, health plans, hospitals and large health systems have started to operate permanent supportive housing (PSH) programmes as a healthcare benefit. To better understand patient perceptions of care coordination in a PSH programme operated by a large health plan in Southern California, we conducted 22 semi-structured in-depth patient interviews between October and November 2019. Two coders analysed these data inductively and deductively, using pre-identified domains and open coding.Coding reliability and thematic saturation were also assessed. Findings indicated

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“…Given their expanding role in health care and potential to leverage resources, we theorize health systems could be better positioned to overcome barriers and support PCR. 11,[18][19][20] For this study, we define a health system as at least one hospital and one physician organization, where affiliation may occur through shared ownership or a contractual relationship for payment and service delivery. 20 Adding to growing pressure to increase efficiency and control costs, capital constraints, regulatory changes, and value-based payment are driving the consolidation of health care providers into vertically integrated health systems, thereby significantly increasing the number of physicians who fall under the influence of a health system.…”

Section: Introductionmentioning

confidence: 99%

“…Many freestanding primary care practices may encounter substantial barriers when redesigning care delivery. Given their expanding role in health care and potential to leverage resources, we theorize health systems could be better positioned to overcome barriers and support PCR 11,18‐20 . For this study, we define a health system as at least one hospital and one physician organization, where affiliation may occur through shared ownership or a contractual relationship for payment and service delivery 20 …”

Section: Introductionmentioning

confidence: 99%

Understanding how health systems facilitate primary care redesign

Harvey

Vanderbrink

Mahmud

et al. 2020

Health Services Research

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Objective To understand how health systems are facilitating primary care redesign (PCR), examine the PCR initiatives taking place within systems, and identify barriers to this work. Study Setting A purposive sample of 24 health systems in 4 states. Study Design Data were systematically reviewed to identify how system leaders define and implement initiatives to redesign primary care delivery and identify challenges. Researchers applied codes which were based on the theoretical PCR literature and created new codes to capture emerging themes. Investigators analyzed coded data then produced and applied a thematic analysis to examine how health systems facilitate PCR. Data Collection Semi‐structured telephone interviews with 162 system executives and physician organization leaders from 24 systems. Principal Findings Leaders at all 24 health systems described initiatives to redesign the delivery of primary care, but many were in the early stages. Respondents described the use of centralized health system resources to facilitate PCR initiatives, such as regionalized care coordinators, and integrated electronic health records. Team‐based care, population management, and care coordination were the most commonly described initiatives to transform primary care delivery. Respondents most often cited improving efficiency and enhancing clinician job satisfaction, as motivating factors for team‐based care. Changes in payment and risk assumption as well as community needs were commonly cited motivators for population health management and care coordination. Return on investment and the slower than anticipated rate in moving from fee‐for‐service to value‐based payment were noted by multiple respondents as challenges health systems face in redesigning primary care. Conclusions Given their expanding role in health care and the potential to leverage resources, health systems are promising entities to promote the advancement of PCR. Systems demonstrate interest and engagement in this work but face significant challenges in getting to scale until payment models are in alignment with these efforts.

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Alternative Payment Models and Team-Based Care

Cited by 6 publications

References 9 publications

A Shortage of Neurologists – We Must Act Now

A Shortage of Neurologists – We Must Act Now

Perceived care coordination among permanent supportive housing participants: Evidence from a managed care plan in the United States

Understanding how health systems facilitate primary care redesign

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