Standardizing Industry Framework: The Necessity and Methodology of Aligning Care Coordination Models

Recently, Susan C. Westgate, MBA, MSW, LCSW-C, Director of Community Care Coordination at LifeBridge Health in Baltimore walked us through a framework that she and a colleague developed for an economic model for care coordination programs, and how LifeBridge Health is using some of their research to help create successful care coordination programs.

In their research, Susan and her team identified many hurdles that exist in care coordination – including what the term care coordination means and how to measure its ROI. They also identified important tactics for success. Read a brief recap below and download a recording of the full presentation here.

The Norm for Care is Often Uncoordinated 

National health expenditures will hit $3.35 trillion this year, but within these expenditures, U.S. health care spending is wildly uneven. About 5% of the population – the most frail or ill – account for nearly half the total spending in a given year. The cost of care continues to go up, and there have been dramatic shifts in reimbursements and penalties and incentives, forcing large healthcare organizations to try to adapt and be agile, which is difficult. In addition, there is a perpetual migration of very ill, vulnerable series of populations from the acute to the outpatient setting. With this migration, and with these unique populations, there are often fragmented and siloed care coordination programs. So how do we prioritize patients and align programs? How to organize the chaos is a challenge that care coordination presents, but sometimes the programs themselves create more complexity. This is what Susan and her colleagues discovered.

Defining a Method and Evaluating Impact

Care coordination efforts are wildly deployed, wildly defined and inconsistently evaluated. The need for best practices and standardization of vernacular is crucial for success. Susan and her LifeBridge colleagues saw the need to research and to compare their proposed model with industry models. In a forthcoming whitepaper they will share an in-depth analysis of their findings, however it is clear there are some key challenges to consider:

  • Who is running this program and where is it positioned within your organization?
  • Which patients do you prioritize for services? Who are they and where are they?
  • How do you establish an economic model for care coordination? Building, implementing, and creating milestones are important.

While care coordination programs are perceived as cost savers, there is no economic tool to evaluate impact. Despite these intrinsic challenges, Susan and her colleagues worked through these considerations – and others – and identified several operational and patient engagement tactics for success.

To learn more about how LifeBridge worked towards aligning care coordination models, download the full webinar recording.