Financing and Payment Options for Care Coordination A Meeting Convened by the National Coalition on Care Coordination (N3C) Wednesday, June 3, 2009 in Washington, D.C. Ken Coburn, MD, MPH, the CEO and Medical Director of Health Quality Partners was invited to serve as a discussant at this thought provoking meeting attended by a cross-cutting group of leaders from advocacy, service, funding, government and policy organizations with broad insights and experiences in this field. Discussion was stimulated by a draft paper on the subject authored by Robert Berenson, MD and Julianne Howell, PhD which incorporated and extended the insights from a previously N3C commissioned report by Randall Brown, PhD "The Promise of Care Coordination: Models that Decrease Hospitalizations and Improve Outcomes for Medicare Beneficiaries with Chronic Illnesses".
Coburn suggested that learnings from the use of multidisciplinary team models in the context of caring for people living with HIV / AIDS within the New York State Designated AIDS Center model could provide insights on how government can explicitly define such standards. The need for a similar model of advanced, multidisciplinary, care coordination and support now exists for millions of chronically ill older adults who frequently also have challenging social, behavioral, and economic risk factors for poor health outcomes. Keys to the successful development of such a model (and its financing and payment) include;
- A clear, measurable, and consistent definition of the outcomes (value) required - e.g., cost savings, quality of life, etc.
- Evidence-based policy making - data must prevail over self-interests of constituencies seeking influence or monetary gain, and advocacy on the part of people in need of such services must be the guiding force to advance progress in this field
- A new infrastructure for robust research dedicated to rapidly and robustly expanding the evidence-base for care coordination is needed for sound policy making
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