Slide 11

Priority #4: Promoting effective communication and coordination of care.

Examples of Federal Initiatives Related to Priorities

• Advancing Primary Care Services and Medical Homes: The Federal government is promoting better care coordination through multiple programs. In November 2010, the Centers for Medicare & Medicaid (CMS) announced: (1) the participation of eight States in the Multi-Payer Advanced Primary Care Practice Demonstration; (2) support to help States establish "health homes" to provide care to Medicaid beneficiaries with at least two chronic conditions; (3) the participation of up to 500 Federally Qualified Health Centers to test the effectiveness of health professionals working in teams to treat low-income patients at community health centers; and (4) the opportunity for States to apply for contracts to support development of new integrated care models. http://innovations.cms.gov/news/pressreleases/pr110910.shtml
• Developing Accountable Care Organizations: As part of the Affordable Care Act, Congress directed CMS to establish a "shared savings program" to bring together groups of providers and suppliers to deliver better quality and more cost-effective care for Medicare beneficiaries. CMS is currently engaging with physicians, hospitals, employers, and consumer groups to help plan this program, which the statute requires be established no later than January 2012. For more information, go to https://www.cms.gov/OfficeofLegislation/Downloads/AccountableCareOrganization.pdf [PDF File, Plugin Software Help].
• Improving Care Coordination Through Health Information Technology: A Federal regulation defining the first stage of meaningful use objectives was released in 2010. For more information, go to https://www.cms.gov/ehrincentiveprograms/. Meaningful use of health information technology improves quality by making needed clinical information accessible to all appropriate providers and in a more complete and timely fashion than paper records.

Initial Goals, Opportunities for Success, and Illustrative Measures

Goal: Build a system that has the capacity to capture and act on patient-reported information, including preferences, desired outcomes, and experiences with health care.

Opportunities for success:

• Integrate patient feedback on preferences, functional outcomes, and experiences of care into all care settings and care delivery.
• Increase use of EHRs [electronic health records] that capture the voice of the patient by integrating patient-generated data in EHRs.
• Routinely measure patient engagement and self-management, shared decisionmaking, and patient-reported outcomes.

Illustrative measures:

• Percentage of patients asked for feedback.

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