Improved Outcomes, Increased Patient Satisfaction, Lower Costs Are Hallmarks of Well-Integrated and Well-Coordinated Health Care Delivery
Integrated health care is a comprehensive health care service delivery system, based on strong, well-coordinated primary care, that many health care experts believe can improve patient health and safety, particularly for patients with chronic conditions. Experts also believe such integrated health care can help minimize racial and ethnic health care disparities and lower health care costs.
“Many of the highest-performing health care providers achieve great outcomes by offering well-integrated health care and serving as a medical home for patients,” said
“While we know that well-integrated and well-coordinated care can have a host of benefits – improved health outcomes, better patient experiences, lower costs and fewer medical errors – we do not fully understand the links between good coordination and good outcomes nor have we identified the best pathways to achieving strong care coordination. We believe the studies we are supporting can help bring forth models of integrated health care that will lead to healthier patients and lower costs,” said Beal.
The four research grants are:
$250,000to Baylor College of Medicinein Houston, Texas, to study how primary care medical homes can lower the cost of care and improve the health of children with chronic physical, developmental or behavioral conditions. Upwards of 16 percent of American children are estimated to have special health care needs, and their care accounts for 42 percent of medical expenditures on children in the U.S. Using Medicaid/Children’s Health Insurance Program (CHIP) data for Houston-area children, the researchers will identify a diverse group of children with special health care needs and survey their doctors about the children’s treatment and coordination of their care. To obtain the patient perspective, the researchers will survey the children’s parents about their satisfaction with their youngster’s care. Additionally, the researchers will analyze claims data to see if the children treated by doctors who identify their practice as a primary care medical home have fewer emergency room visits, hospitalizations and other potentially avoidable treatments than children who receive their care from other types of medical practices. The two-year study is being led by Jean Raphael, M.D., M.P.H., assistant professor of pediatrics at Baylor. $250,000to Massachusetts General Hospital(MGH) in Boston, Mass., to study whether intensive care management and integrated care can improve the health outcomes of economically disadvantaged patients with multiple chronic conditions while decreasing the cost of their treatment. The research team, led by Lisa I. Iezzoni, M.D., M.Sc., professor of medicine at Harvard Medical Schooland director of the Mongan Institute for Health Policyat MGH, will evaluate a new integrated primary care program launched in 2010 by Cambridge Health Alliancethat serves a diverse population of low-income children and adults with two or more chronic conditions. The Massachusetts-based program assigns each patient to a primary care doctor who coordinates treatment, and, as needed, adds an interdisciplinary team of nurse practitioners, clinical nurse psychologists, social workers and community health workers to help patients manage their health. The two-year study will examine the barriers in implementing the program, assess patient satisfaction with the program’s care coordination, communication and quality, and quantify the cost of care. $250,000to the University of California, San Francisco(UCSF) for a two-year study to create a rigorously tested survey tool to assess integrated care around the country. The research will be among the first to develop metrics of integrated care based on the needs, experiences and expectations of patients with chronic conditions. By focusing on the patient experience to create measurements of integrated care practices, the researchers expect their measurement tools to assess these concepts more systematically among diverse patient populations and in a wide range of practice settings. Based at San Francisco General Hospitaland Trauma Center (SFGH), the research is being co-led by Kevin Grumbach, M.D., chair of the UCSF Department of Family and Community Medicineand Chief of Family and Community Medicine at SFGH, and Kara Odom Walker, M.D., M.P.H., assistant professor at UCSFand a physician at SFGH Family Health Center. $250,000to the University of Floridain Gainesvillefor a two-year study exploring whether primary care medical homes can improve the health of patients with diabetes. Currently, 24 million Americans are living with diabetes, a chronic disease that requires patients to take an active role in monitoring their diet and glucose levels to manage the disease successfully. The researchers, led by Allyson HallPh.D., associate professor in the Department of Health Services Research, Management and Policyat the University of Florida’s College of Public Healthand Health Professions, will examine if the primary care medical home model increases patient engagement with managing their diabetes and if increased patient engagement leads to better health. Four Jacksonville, Fla., patient-centered medical home practices, each serving a racially and socio-economically diverse population, will be the sites of the research.
Integrated care is one of the Aetna Foundation’s three program areas, along with fighting obesity and promoting racial and ethnic equity in health and health care. Recently, the