Página inicial | Valora PEAPO | Enlaces | FAQ |
When you think about managing chronic or complex health issues, you want a system that doesn’t leave you navigating care alone. Partners Healthcare takes a team-based approach, connecting specialists, primary care, and community resources for smoother, coordinated treatment. You’ll notice how data and communication drive decisions, all focused on real results for your health. But what exactly sets their integrated care model apart—and how does it impact your daily wellbeing?
Chronic and complex conditions present significant challenges for both patients and the healthcare system. Integrated care models, such as those implemented at Mass General Brigham through the iCMP program (previously known as Partners HealthCare), provide a structured approach to managing these conditions more effectively.
The iCMP program focuses on delivering team-based care specifically to patients with multiple chronic conditions, including heart failure. A substantial portion of its participants, approximately 65 percent, are Medicare beneficiaries. This demographic is often characterized as high utilizers of healthcare services, making the program particularly relevant in addressing their needs.
Evidence suggests that the iCMP program is successful in reducing hospitalizations, emergency department visits, and overall healthcare costs per patient. Key to this success is the use of analytics, claims data, and predictive modeling software to identify individuals who would benefit most from the program's interventions.
Additionally, the initiative emphasizes the coordination of community services and promotes patient-centered care, which enhances communication among healthcare providers and contributes to improved quality of life for patients.
This integrated care approach reflects a shift towards more comprehensive management strategies for chronic conditions, highlighting the importance of collaborative efforts in the healthcare sector. The systematic analysis and use of data to inform patient care decisions stand as critical components of this model.
A comprehensive data-driven strategy underpins patient identification and enrollment within the iCMP program. The integration of analytics tools, such as the Health Catalyst® Platform, utilizes claims data and predictive modeling to effectively identify patients within the General, Brigham, and Mass healthcare systems.
This program specifically targets individuals at risk of hospital admissions or emergency department utilization, particularly those with multiple chronic conditions or specific disease states, including heart failure.
Primary care physicians, Medicare providers, and community health organizations play a critical role in this process by reviewing and referring high utilizers, medically complex patients, or those from underserved populations.
The program has successfully enrolled approximately 14,000 individuals per population, which has been shown to enhance quality of life and treatment outcomes. Furthermore, this approach has implications for reducing healthcare costs and promoting financial sustainability for healthcare organizations.
The Integrated Care Management Program (iCMP) was established in 2006 by Mass General Brigham to provide coordinated support for individuals with complex, high-risk healthcare needs, primarily focusing on Medicare beneficiaries. The program employs a triad care team model, which includes a care coordinator, a social worker, and a disease manager, all aiming to effectively address the challenges associated with managing medically complex patients.
To identify individuals who would benefit from the program, iCMP utilizes risk predictive modeling software and analytics. This approach helps in recognizing high utilizers with multiple chronic conditions, directing them toward appropriate enrollment in the program.
Additionally, the iCMP PLUS extension is designed to tackle ultra-high-risk cases by offering home-based solutions. This variant of the program emphasizes connecting patients to community resources, various providers, and services, ensuring comprehensive support that can enhance treatment coordination.
Overall, the structure and operation of the iCMP reflect a targeted strategy to manage complex healthcare needs while aiming to improve patient outcomes through interdisciplinary collaboration and resource availability.
The iCMP program at Mass General Brigham demonstrates a measurable impact on patient outcomes and healthcare utilization. Data indicate a 20 percent reduction in hospital stays and a 13 percent decrease in emergency department visits for participants in the program.
Additionally, individuals with multiple chronic conditions have reported a 25 percent lower mortality rate.
The program employs predictive modeling and analytics to identify high utilizers of healthcare services, facilitating more coordinated care. Collaboration among diverse team members, including managers and social workers, aims to minimize healthcare costs effectively.
Financially, the iCMP program reports net savings of 7 percent and a return of $2.65 for every dollar invested, underscoring its potential to contribute positively to healthcare expenditure management.
Mass General Brigham’s iCMP program continues to develop its integrated care model, currently benefiting over 20,000 patients, with approximately 14,000 actively enrolled at any given time.
Looking forward, the program aims to expand its services to include pediatric patients and to fully incorporate social workers and community health workers. This initiative addresses the medically complex needs of the population more effectively.
The program will utilize risk predictive modeling software and analytics to identify high-utilizing patients, with the objective of decreasing emergency department visits and controlling healthcare expenditures.
By enhancing the integrated team approach, the program seeks to improve quality of life, facilitate treatment coordination, and optimize patient outcomes, aligning with the strategic vision set forth by Partners (formerly Partners HealthCare).
The emphasis on data-driven decision-making underscores the program’s commitment to delivering effective integrated care solutions.
By choosing Partners Healthcare, you benefit from an integrated care system that puts your health at the center. You’ll experience coordinated services, evidence-based practices, and ongoing communication among your care team. This approach not only addresses your immediate needs but also supports long-term health through continuous improvement and community engagement. As Partners Healthcare looks ahead, you can expect even more innovative programs designed to improve outcomes and deliver comprehensive care tailored to your needs.
 |
Todas las imágenes y pictogramas que esteis utilizando y querais compartir, remitidlas como ficheros adjuntos pinchando el sobre del marco superior, las incorporaré con vuestra referencia a la galería correspondiente o crearé otra galería específica. |