The Fragmentation of U.S. Health Care

Elhauge, Einer

doi:10.1093/acprof:oso/9780195390131.001.0001

Cited by 73 publications

(42 citation statements)

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“…8 Together with good information systems and compensation arrangements, vertical integration of complementary health care entities can achieve important efficiencies by reducing medical errors, obviating duplicative services and facilities, and coordinating elements needed to deliver highquality, patient-centered care. 9 However, the PPACA invites not just vertical integration of complementary elements but also horizontal integration of competitors.…”

Section: Acos In Theory and Practicementioning

confidence: 99%

A Cautious Path Forward on Accountable Care Organizations

Richman

2011

JAMA

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Section: Acos In Theory and Practicementioning

confidence: 99%

A Cautious Path Forward on Accountable Care Organizations

Richman

2011

JAMA

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“…3,4 Care coordination is an intuitively appealing approach to increasing the quality of care and reducing health care spending because it aims to effectively manage chronic conditions, thereby reducing the need for costly hospital stays, improving communication among patients and providers, and better addressing the patient's diverse and complex needs. 5 However, empirical evidence to support the effectiveness of care coordination has been lacking.…”

Section: Care Coordination Program For Washington State Medicaid Enromentioning

confidence: 99%

Care Coordination Program For Washington State Medicaid Enrollees Reduced Inpatient Hospital Costs

2015

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Managing clinically complex populations poses a major challenge for state agencies trying to control health care costs and improve quality of care for Medicaid beneficiaries. In Washington State a care coordination intervention, the Chronic Care Management program, was implemented for clinically complex Medicaid beneficiaries who met risk criteria defined by a predictive modeling algorithm. We used propensity score matching to evaluate the program's impact on health care spending and utilization and mortality. We found large and significant reductions in inpatient hospital costs ($318 per member per month) among patients who used the program. The estimated reduction in overall medical costs of $248 per member per month exceeded the cost of the intervention but did not reach statistical significance. These results suggest that well-designed targeted care coordination services could reduce health care spending for Medicaid beneficiaries with complex health care needs.

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“…This could be done by creating a home health care tab in the user interface to allow physicians and nurses to view recorded home health care data of the patient. However, this would be prohibitively costly at this time due to the complexity of integrating software systems and the fragmentation of the EMR systems market (Elhauge, 2010). A second and more feasible way would be to create a separate parallel home health care system that could be loosely integrated to the provider's EMR system.…”

Section: Logistics Of Data Sharingmentioning

confidence: 99%

“…As mentioned above, the long-term goal is to integrate the home health care HIT into the EMR systems used by physicians and hospitals. However, the EMR systems market is highly fragmented (Elhauge, 2010), which means that a home health care portal would have to be separately integrated to each EMR system. Further, many home health care agencies build their own implementation, resulting in the problem of integrating a set of EMR systems with a set of home health care systems.…”

Section: Data Integrationmentioning

confidence: 99%

Adding Home Health Care to the Discussion on Health Information Technology Policy

Ruggiano

Brown

Hristidis

et al. 2013

Home Health Care Services Quarterly

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The potential for health information technology to improve the efficiency and effectiveness of health care has resulted in several U.S. policy initiatives aimed at integrating health information technology into health care systems. However, home health care agencies have been excluded from incentive programs established through policies, raising concerns on the extent to which health information technology may be used to improve the quality of care for older adults with chronic illness and disabilities. This analysis examines the potential issues stemming from this exclusion and explores potential opportunities of integrating home health care into larger initiatives aimed at establishing health information technology systems for meaningful use.

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The Fragmentation of U.S. Health Care

Cited by 73 publications

References 0 publications

A Cautious Path Forward on Accountable Care Organizations

A Cautious Path Forward on Accountable Care Organizations

Care Coordination Program For Washington State Medicaid Enrollees Reduced Inpatient Hospital Costs

Adding Home Health Care to the Discussion on Health Information Technology Policy

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