Enabling Collaborative Healthcare Delivery: Care Coordination Strategies With 21st Century Technology

In 2003, the Institute of Medicine (IOM) identified care coordination as one of its 20 national priorities for quality. Since then, other prominent organizations, such as the Centers for Medicare and Medicaid Services (CMS), the Commonwealth Fund, the National Quality Forum, and the World Health Organization, have recognized care coordination as a key component for improving healthcare delivery. Gaps in care have been well documented for their contribution to errors, cost, delayed diagnoses and unnecessary or duplicate services and tests (which negatively impact patient safety and satisfaction), and the healthcare system's overall effectiveness and efficiency. More than eight years later, however, the industry is still hampered in its efforts to move to a more coordinated delivery model, largely due to a reimbursement structure that rewards volume over value, an entrenched culture and significant lack of financial, human and IT resources.

The private and public sectors have sought to break down these barriers. Under the Patient Protection and Affordable Care Act of 2010, accountable care organizations (ACOs) — a new payment and delivery reform model that aligns overall quality and coordination of care with cost — can participate in the Medicare Shared Savings Program beginning in January 2012. In September 2011, CMS announced the Comprehensive Primary Care Initiative, a new program under the Center for Medicare and Medicaid Innovation (CMI). CMI's mission is to transform Medicare, Medicaid and the Children's Health Insurance Program through improvements in the healthcare system and by the identification, selection and evaluation of models that support its mission. Primary care physicians (PCPs) who provide better care coordination will receive extra Medicare payments under this new program.