Primary Care Based Population Health in a Community Health System: Evaluation of Strategies, Lessons Learned and Key Results

Population Health;Primary Care;PCMH;ACO;Value-Based;Healthcare Leadership & Management

Priolo, Megan M.Smith, Katherine Clegg ;

Johns Hopkins University

关键词: Population Health;    Primary Care;    PCMH;    ACO;    Value-Based;    Healthcare Leadership & Management;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/44663/PRIOLO-DISSERTATION-2017.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

Theory: As value-based programs continue to proliferate, healthcare delivery providers must adapt accordingly to meet these new demands.This study examines the strategies, lessons learned, and key results of the Greater Baltimore Health Alliance (GBHA), a patient-centered medical home (PCMH) community healthcare provider, in the population health context.Methods: This study follows the work-place challenge format and as such includes an organizational assessment, plan for new service, program evaluation, economic evaluation, and discussion of implications.The organizational assessment leverages survey tools to study GBHA staff and leaders using the Baldrige Excellence Framework.The plan for new services outlines a plan and early results for integrated behavioral health in the PCMH setting.The program evaluation includes a run chart analysis, bivariate analysis, and logistic regression analysis to study colorectal cancer screening compliance rates at GBHA.The economic evaluation methods include a cost consequence analysis and return on investment analysis for GBHA.The implications section leverages a literature review and general discussion.Results: The organizational assessment of GBHA revealed strengths in leadership, strategy, workforce and operations.The organizational assessment also indicated that GBHA has opportunity for improvement in the areas of customers, measurement, analysis and knowledge management, and results.The plan for new service revealed a nearly completed implementation of integrated behavioral health and early results indicate further opportunity for outcome measure refinement, workflow standardization, policy and procedure development, and the establishment of goal thresholds.The program evaluation indicated special cause variation in the run chart as well as increased odds of screening for patients seen in practices with greater length of time recognized as a PCMH. The economic evaluation indicated significant investment in GBHA, largely positive quality outcomes, and progressively increasing return on investment each fiscal year.The discussion of implications underlined the importance of GBHA to stay abreast of federal regulations, which may dictate strategy changes.Conclusions: GBHA has been largely successful in meeting the evolving demands of the population health landscape.GBHA’s location in Maryland provides additional financial incentive to make investment in PCMH strategies more feasible.Additional study is necessary as the behavioral health integration implementation continues.