5 Steps For Creating A Comprehensive Care Management Model

Today, the quality of care provided and the rate of positive outcomes trump all other parameters when it comes to choosing the right physician. Read further to learn how you can become a healthcare facility of choice by adopting the new principles of Care Management.

Patients have increasingly begun seeking healthcare facilities that are mindful of their physical and emotional requirements. They also tend to choose entities that take care of keeping costs in check. While Care Management has always been around as a concept that aims at keeping patients at the epicenter and minimizing wastage, it has been implemented sporadically in the past. However, today, there is a need for converting this initiative into a more continual one so that patient satisfaction is maintained throughout the health care lifecycle. The modern-day Comprehensive Care Management Model is built keeping in mind all these needs as well as changes that the healthcare sector has undergone in recent times. It acts on the basis of new incentives, new payment models, and new alignments. The success of such a model relies heavily on its emphasis on quality, evidence-based medicine, data, financial optimization, and active involvement of physicians.

If you are in the process of redesigning your Care Management model, it is vital to follow the steps listed below:

  1. Invest In An Appropriate IT System – A Care Management program is much more effective if it is backed by an IT framework which provides a single platform for activities like claims management, quality metrics, reporting, data mining and analysis, utilization, and compliance. Such a system creates a smooth experience and, therefore, has more acceptance among staff. It creates a seamless flow of data between the EHR, claims system, customer service systems, online portals for patients and physicians, credentialing system, and financial systems. It also helps aggregate all relevant information like the status of claims, lab reports, ER testing, and results of diagnostic testing conducted at other facilities, making it easier for physicians to work in tandem.
  2. Set Up Operational Processes That Create Continuity – In both outpatient and inpatient settings, continuity of care is essential. Processes that can accomplish this as well as fine-tune themselves in response to regulatory changes and modifications in patient's clinical requirements can contribute to the success of a Care Management program. The first step towards building such processes is making sure that relevant data is readily available in an actionable and accurate form.
  3. Build Strong And Committed Teams – Integrated teams that consist of members who whole-heartedly agree with the principles of the Care Management program are a must-have for the success of such an initiative. A perfect setup for implementing a Care Management program is a learning organization where physicians and other staff members spend time with each other and seek guidance from each other.
  4. Train Your Physicians Adequately – Physicians are the backbone of any successful Care Management initiative. Without their buy-in and input, any steps taken in the direction of embracing the new principles of Care Management will likely fail. For physicians to be committed to these principles, it is essential for them to be trained in this area. Such education should ideally commence in medical school and then continue through the residency program.
  5. Set Up A Regular Reporting Mechanism – A reporting method that helps analyze interventions and ensuing results is a critical piece of any Care Management program. Such a mechanism helps quantify the effects of evidence-based protocols, making it easier for you to determine improvement measures.

A Comprehensive Care Management Model that is designed in the form of a closed loop helps enhance patient care and also allows physicians to enjoy the professional fulfillment that comes as a result of practicing good medicine.

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