Making Medical Homes Work: Moving From Concept to Practice

Explores practical considerations for implementing a medical home program of physician practices committed to coordinating and integrating care based on patient needs and priorities, such as how to qualify medical homes and how to match patients to them

The Veterans Health Administration: Taking Home Telehealth Services to Scale Nationally

Since the 1990s, the Veterans Health Administration (VHA) has used information and communications technologies to provide high-quality, coordinated, and comprehensive primary and specialist care services to its veteran population. Within the VHA, the Office of Telehealth Services offers veterans a program called Care Coordination/Home Telehealth (CCHT) to provide routine noninstitutional care and targeted care management and case management services to veterans with diabetes, congestive heart failure, hypertension, post-traumatic stress disorder, and other conditions. The program uses remote monitoring devices in veterans' homes to communicate health status and to capture and transmit biometric data that are monitored remotely by care coordinators. CCHT has shown promising results: fewer bed days of care, reduced hospital admissions, and high rates of patient satisfaction. This issue brief highlights factors critical to the VHA's success -- like the organization's leadership, culture, and existing information technology infrastructure -- as well as opportunities and challenges

HITECH Revisited

Assesses the 2009 Health Information Technology for Economic and Clinical Health Act, which offers incentives to adopt and meaningfully use electronic health records. Recommendations include revised criteria, incremental approaches, and targeted policies

Taxonomic classification of planning decisions in health care: a review of the state of the art in OR/MS

We provide a structured overview of the typical decisions to be made in resource capacity planning and control in health care, and a review of relevant OR/MS articles for each planning decision. The contribution of this paper is twofold. First, to position the planning decisions, a taxonomy is presented. This taxonomy provides health care managers and OR/MS researchers with a method to identify, break down and classify planning and control decisions. Second, following the taxonomy, for six health care services, we provide an exhaustive specification of planning and control decisions in resource capacity planning and control. For each planning and control decision, we structurally review the key OR/MS articles and the OR/MS methods and techniques that are applied in the literature to support decision making

State Strategies to Improve Quality and Efficiency: Making the Most of Opportunities in National Health Reform

Examines ten states' initiatives to address key components of quality and efficiency improvement, including data collection, aggregation, and standardization; public reporting; payment reform; consumer engagement; and provider engagement

Crossing Organizational Boundaries in Palliative Care: The Promise and Reality of Community Partnerships

This report presents the first of a series of findings from the Community-Oriented Palliative Care Initiative (COPCI), an innovative program testing new approaches to caring for individuals with progressive, life threatening illness. Developed and supported by the United Hospital Fund, the project was designed to initiate collaborations among health care and social service organizations, with the goal of reaching seriously ill individuals and their caregivers earlier in the course of illness and providing a broad range of coordinated services. Six such networks of diverse partners received a total of $2.1 million in grants over the two-year period from mid-2000 into 2002.The urgency to provide alternatives to current standard practice is underscored by the number of individuals affected: in New York City alone, in the year 2000, some 46,000 people died of diseases typically marked by a lengthy course from diagnosis to death. While many could have benefited from appropriate and timely palliative care services, most did not receive them.The Fund reasoned that networks including not only hospitals and hospices but also social services agencies and other community resources could collectively respond, earlier and more fully, to the complex combination of medical, social, psychological, and spiritual needs that typify the months and years leading to death. Local expertise and resources should determine the structure of each network, the partners involved, and the specific model for service delivery. Drawing on the experiences of the six pioneering projects, this report focuses on the challenges of creating such new networks

Can This Marriage Be Saved?

Market forces in health care are paradoxically pulling physicians and hospitals apart and together at the same time. What are these forces and trends? Is the long-standing marriage of interdependence and productivity between them destined to fail, or can it be saved and even strengthened by emerging delivery and governance models in the so-called "market revolution" of consumer-driven health care? What are the implications for health care policy and practice? These are issues we explore in this Arizona Health Futures Policy Primer