Holder Diane, Keyser Donna, Kogan Jane, Hurford Matthew O, Lovelace John, Schuster James
UPMC Pittsburgh Pennsylvania USA.
UPMC Insurance Services Division Pittsburgh Pennsylvania USA.
Learn Health Syst. 2025 Feb 12;9(3):e10477. doi: 10.1002/lrh2.10477. eCollection 2025 Jul.
To accelerate transformation toward value-based, equitable care, health systems need a viable approach for engaging and aligning multiple stakeholders to promote innovation. Building and sustaining learning communities offers one possible solution.
We describe how one learning community has leveraged the collective strengths, assets, and expertise of multiple stakeholders to improve care value for subpopulations who experience low-quality, high-cost, and/or inequitable health outcomes.
By providing critical infrastructure and support, UPMC's Learning Community was able to (1) accelerate adoption of risk-based payment models that promote shared accountability among providers, payers, and families/caregivers for the total costs of care of children and adolescents with medically complex conditions, (2) drive widespread practice change for improving physical and mental wellness for individuals with serious mental illness, and (3) increase access to evidence-based treatment and improve outcomes for individuals with opioid and substance use disorders.
Learning communities can serve as important catalyzers for the payment, practice, and service delivery innovation necessary to achieve a high-value, equitable health system.
为加速向基于价值的公平医疗转变,卫生系统需要一种可行的方法来促使多个利益相关者参与并保持一致,以推动创新。建立和维持学习型社区提供了一种可能的解决方案。
我们描述了一个学习型社区如何利用多个利益相关者的集体优势、资产和专业知识,为经历低质量、高成本和/或不公平健康结果的亚人群改善医疗价值。
通过提供关键的基础设施和支持,匹兹堡大学医学中心(UPMC)的学习型社区能够:(1)加速采用基于风险的支付模式,这种模式促进了提供者、支付者和家庭/照顾者对患有复杂医疗状况的儿童和青少年的总医疗费用承担共同责任;(2)推动广泛的实践变革,以改善患有严重精神疾病的个体的身心健康;(3)增加获得循证治疗的机会,并改善患有阿片类药物和物质使用障碍的个体的治疗效果。
学习型社区可以成为实现高价值、公平卫生系统所需的支付、实践和服务提供创新的重要催化剂。