Todd P. Gilmer (
Marc Avery is a clinical professor of psychiatry and behavioral sciences at the University of Washington, in Seattle.
Health Aff (Millwood). 2018 Sep;37(9):1442-1449. doi: 10.1377/hlthaff.2018.0372.
This article reports how a large Medi-Cal managed care plan addressed challenges in accessing health care for approximately 7,000 enrollees with multiple chronic conditions through a project known as the Behavioral Health Integration and Complex Care Initiative. The initiative increased staffing for care management, care coordination, and behavioral health integration. In our evaluation of the initiative, we demonstrated that participation in it was associated with improved clinical indicators for common chronic conditions, reduced inpatient costs in some sites, and improved patient experience in all sites. The initiative may be best understood as a new type of ongoing strategic partnership among the health plan, its providers, and their patients. Changes in funding to support models of value-based care are needed to sustain these efforts in the long term.
这篇文章报道了一家大型医疗补助管理式医疗计划如何通过一项名为“心理健康整合和复杂护理计划”的项目,解决约 7000 名患有多种慢性疾病的参保者获得医疗服务的难题。该计划增加了护理管理、护理协调和心理健康整合方面的人员配置。在对该计划的评估中,我们证明参与该计划与常见慢性病的临床指标改善、一些地点的住院费用降低以及所有地点的患者体验改善有关。该计划可以被最好地理解为医疗计划、其提供者及其患者之间一种新型的持续战略合作伙伴关系。需要改变资金支持模式以支持基于价值的护理模式,以长期维持这些努力。