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Researchers and healthcare organizations alike recognize the connection between physical conditions and behavioral health conditions and are working to coordinate care between the providers.Many people with chronic diseases also suffer from depression and other behavioral health issues.People with mental health problems die earlier than the general population because they smoke, are overweight, and have chronic illnesses. Behavioral and physical healthcare providers often operate in silos and lack coordination, which can result in a negative impact on individuals.
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Great strides have been made in the treatment of sickle cell disease, the inherited blood disorder that occurs most commonly in African-Americans. Patients with the disease used to die before reaching adulthood, but today many patients live well into their 40s and beyond.
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As payers and providers recognize the value of care coordination for people with chronic conditions and complex care needs, opportunities are opening up for case managers in primary care practices.
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The Centers for Medicare & Medicaid Services (CMS) has started pilot testing of two more survey tools to go with the infection control pilot it began testing last year.
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The Joint Commissions Center for Transforming Healthcare has started working with 20 hospitals in South Carolina to improve their safety by examining systems, processes, and structures in an effort to minimize variability in practices.
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Hospitals that have physician offices connected to and affiliated with them now have another option for getting certified for a Primary Care Medical Home. Along with programs run by the National Committee for Quality Assurance (NCQA), The Joint Commission started offering such certification in late February.
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A study of three primary care practices that participate in Cignas Collaborative Accountable Care model, which includes care coordination for at-risk patients, showed significant cost savings and improved quality of care when compared with other practices in the same geographic area.
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Aetna started partnering with physician practices to improve outcomes by coordinating care in 2007 before the term accountable care came into use, says Randall Krakauer, MD, national medical director for Aetna Medicare.
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Since Advocate Health Care began embedding case managers in primary care offices, hospital admissions and emergency department visits have decreased and length of stay has dropped, says Sharon Rudnick, vice president of outpatient care management for the Chicago-based health system.
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After a program to reduce readmissions showed positive results but not a clear downward trend in readmissions, Capital District Physicians Health Plan (CDPHP) is trying another tactic.
