Healthcare Innovation in new models of care

Last three years have been very critical, as healthcare providers’ passion for patient care is leading to the discovery of new models to more efficiently deliver quality care while reducing costs.

After writing my last article on the disparities of healthcare, I wanted to see what new innovations were coming up in this area. In today’s healthcare delivery, reimbursement is changing. It is more focused on outcomes than fee-for-service and hospitals focus on population health management.

Below are the different models of care: 

Medical or health home – 

Medical home is an enhanced primary care delivery model that strives to achieve better access, coordination of care, prevention, quality, and safety within the primary care practice, and to create a strong partnership between the patient and primary care physician.  In the model, payers often reward providers with a member per month “bonus” for improving primary care services for each patient in the medical home. This was designed around patient needs and aims to improve access to care.

Accountable Care Organization – 

These are bigger organizations that have the ability to better manage the care for a greater population of people with a larger budget for better overall cost management, less variation within the population, and the ability to track and trend for quality. Groups of doctors, hospitals, and other healthcare providers, who come together voluntarily to give coordinated high quality care to their Medicare patients.

IORA healthcare – 

IORA Health, a private healthcare company, provides a radically different model of primary care. IORA healthcare believes that healthcare starts with better primary care. Team-based care that puts the patient first, a payment system based on care, with billing codes and technology built around people, not processes.

Nurse-managed Health Clinics (NMHCs) – 

These are provider mix that is richer in nurse practitioners and physician assistants is today’s predominant model of care delivery.

Retail Clinics - 

Retail clinics are coming up very quickly. They are medical clinics located in pharmacies, grocery stores, and major retailers such as Wal-Mart, and even hospitals. The clinics are filling a need for convenience, cost and a more consumer-like approach to health care. Care is usually delivered by a nurse practitioner.

Hospital branded urgent care–

 These are urgent care hospital-branded facilities. Many surveys have shown that patients prefer hospital-affiliated urgent care centers, and this often has the added benefit of cementing the patient’s loyalty to a particular hospital in areas where multiple hospital and healthcare choices exist.

One medical –

 Provides boutique medical management consulting, charging up front frees annually for providing quick delivery of good care with belief that clinical excellence, commitment to service, and a modern approach make for a truly great experience.

Hot Spotters –

 (Dr. Jeff Brenner from Camden New Jersey) Focused on areas or people using more of the healthcare dollars. Hot spotter work on prevention, so less use of ER by underserved population.

PACE – 

Program of All-inclusive Care for the Elderly is a Medicare and Medicaid program that helps people meet their health care needs in the community instead of going to a nursing home or other care facility. The program keeps a comprehensive primary care team on site.

Tele health -

 Tele health is the delivery of health-related services and information via telecommunications technologies. It is use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health and health administration. Technologies include videoconferencing, the internet, store-and-forward imaging, streaming media, and terrestrial and wireless communications.

The Chronic Care Model - 

This model, developed by Ed Wagner, this is the model which focuses on all levels with the needs of patients with an increasing burden of chronic illness.

Home-Based Primary Care Practices - Primary care practices focused on providing care in the home are growing rapidly.

Care Oregon – 

It is Medicaid managed care plan based in Portland, Oregon, Care Oregon is an active health system leader for both the Institute for Healthcare Improvement and the Commonwealth Fund.

It is too early to determine which model is the best. Neither the traditional nor the non-traditional models have been evaluated rigorously for their effect on patient safety and quality of care. They all are focusing on different areas of the patient population. Some will work, some will not. Only time will tell.