Kodner Dennis L
Of Integrated Care Group, LLP.
Int J Integr Care. 2015 Sep 23;15:e017. doi: 10.5334/ijic.2245. eCollection 2015 Apr-Jun.
The Massachusetts General Care Management Program (Mass General CMP or CMP) was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS) beneficiaries-primarily older persons-with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each). It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO). The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a "whole systems" approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program includes the staffing structure, standards of practice, collaborative approach to care transitions and information technology tools that were used in the original demonstration project.
马萨诸塞州综合护理管理项目（马萨诸塞州综合CMP或CMP）是一项由联邦政府支持的示范项目，旨在测试基于实践的强化护理管理对高成本医疗保险按服务付费（FFS）受益人的影响，这些受益人主要是老年人，患有多种慢性病且多次住院。马萨诸塞州综合护理管理项目分两个阶段实施，为期6年（各3年）。该项目第一阶段始于马萨诸塞州波士顿的一家主要学术医疗中心——马萨诸塞州综合医院，与马萨诸塞州综合医师组织合作开展。在第二阶段，该项目扩展至波士顿地区及其周边的另外两个附属地点，包括一家社区医院，同时进行了多项改进，主要集中在向熟练护理机构的急性后护理过渡管理方面。2012年7月示范项目结束时，马萨诸塞州综合护理管理项目成为一个新的先锋责任医疗组织（ACO）的组成部分。马萨诸塞州综合护理管理项目关注符合特定资格标准的个体，为他们提供由初级保健实践中嵌入的个案经理整合的护理服务。与传统医疗保险系统中按服务付费的患者相比，该示范项目显示出可观的成本节约，但对医院再入院率没有影响。马萨诸塞州综合护理管理项目并非基于综合护理的“全系统”方法。它是一个很好的例子，展示了如何在现有医疗保健组织中实施创新的护理协调项目，而无需对其基础结构或直接患者护理服务的付费方式进行根本性改变。马萨诸塞州综合护理管理项目的责任医疗组织版本包括了原始示范项目中使用的人员配置结构、实践标准、护理过渡协作方法和信息技术工具。
