Describe one innovative health care delivery model that incorporates an interdisciplinary care delivery team

Neonatal Intensive Care and Breastfeeding Course

The Affordable Care Act contains several provisions that attempt to interlink the quality of care with care costs (McNiff, 2018). By providing incentives for development and integration of innovative care delivery systems and model, the ACA attempts to rebalance the healthcare system allocation of resource and reward the value of care rather than volume of care (Haas, 2011). Two delivery systems mentioned in this law are the Accountable Care Organization and Patient-Centered Medical Home (Haas, 2011).

The law authorizes the establishment of community-based interdisciplinary and inter-professional teams to supposedly support primary care practices (Haas, 2011). The teams discussed include primary care physicians, nurses, nurse practitioners, medical specialists, physicians’ assistants, alternative medicine practitioners, nutritionists, social workers, mental and behaviorist practitioners (Haas, 2011). The role of the health team is to support medical homes. Haas describes patient-centered medical homes as models of care which integrate “personal physicians, whole person orientation, coordinated and integrated care, and evidence-based medicine.”  The medical home model is a patient-based approach the represent a methodology focused on promoting increased collaboration among healthcare stakeholders. This model encourages providers and patients to work together to make sure care is more comprehensive, coordinated, and consistent.

Accountable Care Organizations (ACO) are defined as organizational structures within which healthcare providers and organizations work jointly to offer the most cost effective care (Haas, 2011). ACO promotes patient-centered medical homes. Since ACO is responsive to any of the new payment mechanisms, it appeals to pay-for performance (P4P). (P4P) programs offer financial rewards and incentives or penalties to organizations, groups of providers and individual healthcare providers based on their performance on measures of value and quality (McNiff, 2018). The purpose is to help influence the healthcare systems’ and providers’ behavior to better quality of care delivered, minimize needless use of costly healthcare services, as well as improve patient outcomes (NEJM Catalyst, 2018). P4P is especially pertinent where serious gaps in the healthcare quality is linked to fee-for-service system. It incentivizes organizations and providers that improve quality and lower costs.

P4P programs have shifted focus from basic care delivery to high-quality care delivery (McNiff, 2018). The use of incentives and penalties encourages healthcare organizations to follow best clinical practices and to better patient satisfaction scores through the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) (NEJM Catalyst. (2018). Medical home is understood as a provider who coordinates the care of a patient across settings and providers (Haas). It is promoted through financial incentives to primary care providers to boost preventive care and chronic care management.

EXPLAIN FULLY how this model is advantageous to patient outcomes

The medical home provides distinct set of benefits to patients. the patient is provided with care coordinator at the provider practice level. The role of this care coordinator is to manage the health of the patient across the care spectrum (O’Dell, 2016). The coordinator is responsible for interfacing on behalf of the patient with the specialists, labs, pharmacists and health plans to create a more holistic approach to treatment. The medical home has the potential to achieve improve quality of care and lower costs by coordinating transition between the health setting and case management for patients. Insurers are driving medical homes in order to control costs and enhance patient satisfaction. Health reform by the federal government has prompted expansion of the medical home in federally qualified centers, Medicare and Medicaid (The Henry J. Kaiser Family Foundation, 2017). Investment in the medical home provides savings for patients. the rising cost of healthcare cost in the current economic condition is a burden for many patients and taxpayers.

The medical home offers healthcare which is relationship-based with focus on the whole person. Quality and safety are assured in medical home.  The medical home provides higher quality of care, lowers cost, improves access and coordination of care (NEJM Catalyst, 2018). Providers are required to focus on the whole person, build patient-provider relationships, and collaborate with patients to comprehend patient preferences and needs. Collaborating with patients and fa milieus necessitates understanding and respecting the unique needs, values and preferences of each patient. Recognizing that patients are central members of the health team, this model ensures that patients are fully active participants in developing care plans.

References

Haas, SA. (2011). Health Reform Act: New Models of Care and Delivery Systems. American Academy of Ambulatory Care Nursing. Retrieved on June 23, 2021 from https://www.aaacn.org/health-reform-act-new-models-care-and-delivery-systems

McNiff, P. (2018). Current Trends in Nursing Practice. In Trends in Health Care: A Nursing Perspective. Retrieved on June 22, 2021 from https://lc.gcumedia.com/nrs440vn/trends-in-health-care-a-nursing-perspective/v1.1/#/chapter/2

NEJM Catalyst. (2018)”What Is Pay for Performance in Healthcare?” Retrieved on June 23, 2021 from https://catalyst.nejm.org/pay-for-performance-in-healthcare

O’Dell, M. (2016). What is a Patient-Centered Medical Home? Missouri Medicine, 113;301-304. Retrieved on June 22, 2021 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6139911/

The Henry J. Kaiser Family Foundation. (2017). Summary of the Affordable Care Act. Retrieved on June 22, 2021 from https://files.kff.org/attachment/Summary-of-the-Affordable-Care-Act