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Translating evidence into practice : ACOs’ use of care plans for patients with complex health needs
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Fraze, T. K., Beidler, L. B., Briggs, Adam D. M. and Collatz, C. H. (2021) Translating evidence into practice : ACOs’ use of care plans for patients with complex health needs. Journal of General Internal Medicine, 36 . pp. 147-153. doi:10.1007/s11606-020-06122-4
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WRAP-ACOs-use-care-plans-patients-complex-health-needs-Briggs-2020.pdf - Accepted Version Embargoed item. Restricted access to Repository staff only until 1 October 2021. Contact author directly, specifying your specific needs. - Requires a PDF viewer. Download (1501Kb) |
Official URL: https://doi.org/10.1007/s11606-020-06122-4
Abstract
Background
Care plans are an evidence-based strategy, encouraged by the Centers for Medicare and Medicaid Services, and are used to manage the care of patients with complex health needs that have been shown to lead to lower hospital costs and improved patient outcomes. Providers participating in payment reform, such as accountable care organizations, may be more likely to adopt care plans to manage complex patients.
Objective
To understand how Medicare accountable care organizations (ACOs) use care plans to manage patients with complex clinical needs.
Design
A qualitative study using semi-structured interviews with Medicare ACOs.
Participants
Thirty-nine interviews were conducted across 18 Medicare ACOs with executive-level leaders and associated clinical and managerial staff.
Approach
Development, structure, use, and management of care plans for complex patients at Medicare ACOs.
Key Results
Most (11) of the interviewed ACOs reported using care plans to manage care of complex patients. All care plans include information about patient history, current medical needs, and future care plans. Beyond the core elements, care plans included elements based on the ACO’s planned use and level of staff and patient engagement with care planning. Most care plans were developed and maintained by care management (not clinical) staff.
Conclusions
ACOs are using care plans for patients with complex needs, but their use of care plans does not always meet the best practices. In many cases, ACO usage of care plans does not align with prescribed best practices: ACOs are adapting use of care plans to better fit the needs of patients and providers.
| Item Type: | Journal Article | ||||||||||||||||||||||||
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| Subjects: | R Medicine > RA Public aspects of medicine | ||||||||||||||||||||||||
| Divisions: | Faculty of Medicine > Warwick Medical School > Health Sciences Faculty of Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Medicine > Warwick Medical School |
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| Library of Congress Subject Headings (LCSH): | Primary health care -- Cost effectiveness, Medical care, Cost of -- United States -- Evaluation, Accountable care organizations, Medical care | ||||||||||||||||||||||||
| Journal or Publication Title: | Journal of General Internal Medicine | ||||||||||||||||||||||||
| Publisher: | Springer New York LLC | ||||||||||||||||||||||||
| ISSN: | 0884-8734 | ||||||||||||||||||||||||
| Official Date: | January 2021 | ||||||||||||||||||||||||
| Dates: |
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| Volume: | 36 | ||||||||||||||||||||||||
| Page Range: | pp. 147-153 | ||||||||||||||||||||||||
| DOI: | 10.1007/s11606-020-06122-4 | ||||||||||||||||||||||||
| Status: | Peer Reviewed | ||||||||||||||||||||||||
| Publication Status: | Published | ||||||||||||||||||||||||
| Publisher Statement: | This is a post-peer-review, pre-copyedit version of an article published in Journal of General Internal Medicine. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11606-020-06122-4 | ||||||||||||||||||||||||
| Access rights to Published version: | Restricted or Subscription Access | ||||||||||||||||||||||||
| RIOXX Funder/Project Grant: |
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