FierceHealthcare FierceHealthIT FierceMobileHealthcare FierceHealthPayer
FierceHealthFinance FierceEMR FiercePracticeManagemtn Hospital Impact

Wikio - Top Blogs - Health

Hospital Impact has been ranked one of the top 50 healthcare blogs by Wikio.

Get the RSS Feed


Advertise with us

Contact us

Care coordination movement picks up speed in Maryland hospitals

July 31st, 2014

by Carmela Coyle

With national healthcare leaders and federal regulators focusing now more than ever on how to achieve the triple aim of healthcare--reduced costs, better outcomes and improved patient experience--experiments on the best way to achieve this sprout up throughout the country.

One of the major movements in recent years is a push toward care coordination--the implementation of best practices so that patient care among different healthcare partners like hospitals, pharmacies, nursing homes and primary care physicians is harmonized and best serves the patient. The concept of care coordination has been around for decades, but is only just now maturing.

Here are a few things we know so far from the research about care coordination:

  • When taken in aggregate, care coordination tested in the Medicare program has not moved the needle much on spending
  • Specific care coordination practices, however, have made significant progress in reducing emergency room use, hospital admissions and readmissions, and cost
  • Successful care coordination requires a mix of intense data analysis/patient outcome modeling and personal, intimate knowledge of each patient’s needs


Here in Maryland, under a five-year demonstration agreement with the Centers for Medicare & Medicaid Services, hospitals agreed to operate under fixed global budgets. Overnight, this shift transformed the incentive model from volume to value, and driven hospital leaders to move quickly to implement population health management tools like care coordination.

Here are a few examples from Maryland. One hospital solicited formal requests for qualifications from skilled nursing facilities to determine whether they can help reduce readmissions and ensure alignment of care from the hospital to the nursing home. Another embedded community health workers in a low-income senior housing complex to triage patients' needs on-site. Several have bedside delivery medication programs to make sure patients have their prescriptions in hand before they leave the hospital.

How will all this work in the long-term? Well, by focusing on the most costly, complex cases, hospitals and their partners can customize treatment and care plans to ensure better outcomes. We know that patients with multiple chronic illnesses make up a disproportionate share of cost (chronic conditions account for more than 75 percent of total healthcare spending). But the complex cases are just a starting point. To be truly successful, hospitals in Maryland will have to take a portfolio approach by improving the standard of care for everyone while providing targeted interventions for high-risk patients.

It's still early to tell how these efforts will play out. They've never been tested on a statewide scale like they are now in Maryland. There are some encouraging signs, however, that this will yield very positive outcomes. Here's one that's worth noting: Already, healthcare providers whose only previous contact came through the sharing of standard forms and patient information now regularly talk with one another via email, on the phone, and, yes, in person. And they recognize and internalize the concept that the best care for patients cannot occur in silos, warm handovers are not just a feel-good measure, and healthcare at its best will never, ever be a solo venture.

Carmela Coyle is president and CEO of the Maryland Hospital Association, focusing on advocacy and public policy.


Get Hospital Impact in your inbox!

List in Marketplace | Supplier in Marketplace