By Chad O’Kane
Director of Quality
There is no question that the health care system of our country is in the midst of an intense period of change and transformation. As CMS and other payers test various payment models that increasingly reward providers for providing high value care, what has become evident is that the practices most successful in providing better health and a better experience of care for patients at lower costs are those that are willing to engage in the transformation of the system through advanced models of care.
The aim of EngageQUALITY is to engage with our clients’ practices in innovative ways to achieve success as advanced primary and specialty care practices.
Advanced models of care is care that is patient-centered, continuous, comprehensive, and equitable, as well as team-based and collaborative, coordinated and integrated, accessible, and high value. These fundamentals form the basis of every primary care quality model including:
- Comprehensive Primary Care (CPC)
- Primary Care First (PCF)
- Medicare Shared Savings Program (MSSP)
- Accountable Care Organizations (ACOs)
- Patient-Centered Medical Home (PCMH)
These models also share the same goals of better health, better care, and lower costs.
Care that is patient-centered is care that is focused on the whole person. We take into consideration not only a patient’s presenting physical issue but also their emotional, psychological, and spiritual well-being, along with their cultural, social, and economic circumstances. Patients and families/caregivers are considered equal members of the patient care team. When they are involved in decision-making, better outcomes are achieved.
Types of Care
Care that is continuous is care that provides continuity to patients and their families/caregivers throughout the entire course of their lives, including the end of their lives. It is a relationship with us that is based on a deep knowledge and understanding of them and their unique lives and families.
Care that is comprehensive and equitable is care that addresses all the care needs of our patients with appropriate and timely services whether those are acute, chronic, preventive, or behavioral/mental. It is care that takes into consideration the social factors that affect the health of our patients (e.g., financial, transportation, religious, genetic, their own behaviors, social inequities). To provide care that is comprehensive and equitable, we partner together to ensure we deliver the best possible care.
Care that is team-based and collaborative is care that is provided by an interdisciplinary team including the patient and family/caregivers that is working toward a common goal of promoting better health of the patient. It is characterized by care team members that work at the top of their license so that the patient benefits from the best of each care team member. It is care that is a partnership based on mutual respect and needs of the patient.
Care that is coordinated and integrated is care that integrates the efforts of care team members to ensure the best health and outcomes for the patient. It is characterized by communication, understanding, and collaboration across care settings.
Care that is accessible is care that is available to patients when and how they need it, including personal or virtual visits, extended hours, and same-day access. It is care that is affordable to patients.
Care that is high value is care that provides the best possible outcomes. It is care that is provided with excellence regardless of the patient’s social or economic status. It is care that wisely considers the cost to the patient and to the health care system. High-value care is care where outcomes are improved for populations of patients. It is also care that provides a positive experience for patients and their families.
Why These Fundamentals Matter
These fundamentals of advanced models of care are proven to result in better outcomes for patients, lower costs to the health care system, and greater job satisfaction for health clinicians and staff members. It is these fundamentals that will enable your practice to successfully navigate the ever-changing health care environment and lead to improved outcomes for your patients.
EngageQUALITY is proud to partner with practices that are focused on delivering high value care. Engage with us today and work together to transform care, advance quality, and achieve success.
Chad O’Kane serves as Director of Quality at EngageMED, leading quality and value-based programs including Primary Care First and Medicare Shared Savings Program. With over 20 years of experience in ambulatory quality improvement and practice transformation, his background in ministry fuels his passion for improving patient care.
