Health systems across the nation are testing innovative strategies for improving patient care while reducing costs. Mercy Health St. Mary’s took part in the Center for Medicare & Medicaid Services’ Bundled Payments for Care Improvement Initiative, which piloted several models that tie payments to episodes of care rather than fee-for-service. Mercy Health St. Mary’s developed a comprehensive program to respond to diverse patient needs in hopes of achieving better patient outcomes while lowering costs. The program showed that bundled payment initiatives can not only result in more coordinated care and lower costs, but also offer opportunities to identify and address patients’ barriers to care.
A new Journal of Nursing Administration article, written by Lauran Hardin, Senior Director of Cross Continuum Transformation for the National Center, and Adam Kilian and Elizabeth Murphy of Mercy Health St. Mary’s, identifies six “core values” that encouraged interprofessional collaboration to address patients’ complex health and social needs. They are:
- Partner with existing care management team rather than replacing it
- For each patient, conduct a root cause analysis of the medical, psychiatric, social, and systemic factors that may contribute to instability
- Integrate the analysis in the EMR so all providers know of opportunities to improve care for each patient
- Engage an interprofessional team to provide diverse insights into design, program oversight, and patient care
- Report outcomes and readmission patterns on a weekly basis to facilitate rapid changes to the intervention
- Use data and patterns to drive next steps in the intervention
This is an open-access article available through the Journal of Nursing Administration.