Evaluation of Care Coordination and Care Management Outcomes: Where Do We Go from Here
Goal: To evaluate structures, processes and outcomes and identify key opportunities to improve care management and care coordination, with an emphasis on the quality metrics, as the ACO program moves toward the end of the DSRIP waiver. A secondary goal may be to consider information you wish to share with the State to inform care coordination models for the next 1115 waiver.
Objectives:
- Evaluate structures, processes and outcomes related to care management, care coordination and population health
- Identify and act on opportunities for improvement based on your current efforts, the opportunity to improve care management for your current population and to contribute to the future vision as the State redesigns the 1115 waiver
- To capture and evaluate best practices and related outcomes based on efforts to deliver care management in ACOs and CPs in Massachusetts and in other health care delivery organizations nationally
- To assess partnerships with Community Partners and other organizations to improve care coordination and care management
HPM will work with your ACO or CP to: (i) identify structure, process and outcomes metrics of interest, and areas that you wish to further explore and improve; (ii) conduct best practice research on other ACOs and CPs as well as organizations and care management models nationally to inform your improvement and reporting efforts; (iii) inform improvement efforts; and (iv) help you develop and implement improvement strategies going forward.
The project will be customized based on the needs of the ACO or CP.