An Integration Of Care Study

Integrated Care Collaboration maintains a health information exchange called the ICare system. Through this system Integrated Care Collaboration has worked towards identifying needs of Central Texas and improving healthcare access to those who need it. Integrated Care collaboration has been nationally recognized and has been accredited with the the Texas Health Information Exchange Accreditation Program (TXHIEAP) and the Direct Trusted Agent Accreditation Program (DTAAP). Both accreditation programs are dedicated to ensuring proper use of HIEs and compliance with federal and state laws as well as HIPAA. Texas Health Information Exchange Accreditation program focuses on proper exchange of patient information while Direct Trusted Agent Accreditation Program is geared toward recognizing excellence in data processing and transactions

We can improve partnership working through effective communication and information sharing. By working as a team and having regular staff meetings, with colleagues and other health care professionals.

You have open access to indemnity insurance. You have the right to choose your PCP and it doesn’t matter what your insurance may like. This makes things very convenient considering many people go to the same doctor for the vast majority of their life and solely rely on them for their treatment or care.

Under the HMO, each patient is appointed to a primary care physician (PCP), who is essentially accountable for the long-term care of the members that she/he has been assigned and any specialists that a patient needs to see should be referred by their PCP. Some examples of HMOs are Kaiser Permanente and Humana. HMOs have been licensed at the state level, under a license that is known as a certificate of authority. A pro of an HMO is that treatment for a patient can begin prior to their insurance being authorized; A member may benefit from this because there would be little to no treatment delays. A con of an HMO is that in order to save cost, most HMOs provide narrow provider networks; A member may not benefit if in an emergency because their “in-network” emergency room might be far or there are “quick-care” in their area.

With Aetna HMO, a Primary Care Physician (PCP) gives fundamental social insurance benefits and organizes particular administrations when required. You can pick any PCP from the Aetna network. You will feel great realizing that anybody you pick meets our theirs standards. Picking a doctor is an individual choice, that is the reason every individual from your family can have his or her own particular PCP. You can change your PCP whenever need be. You should pick a PCP and see providers in the network to receive benefits from this plan. When you visit your PCP or a specialist, you will have to pay a copay fee.

“Evidence combined with the growing recognition that physical, mental, substance abuse and social challenges are interrelated-has led to calls to integrate behavioral health care into primary care services.” (Klein & Hostetter, 2014, p. 9) Behavioral health and substance abuse treatment in the primary care office is rare and in some cases non-existent. This is mostly due to no or little financial incentive or administrative advantages to integrating these services within the primary care office. Dr. Roger Kathol, M.D. president of the Cartesian Solutions Inc., believes the biggest obstacle in integrating mental health and substance abuse treatment into the primary care office is low payment from payers. Payers use separate provider networks,

Those PCPs are either dissatisfied with their practice or patients are not satisfied with them for multiple, but fixable problems. This is the area that needs a lot of attention and where money spent will be well-spent. The American Healthcare system is in desperate need of not just increasing the number of primary care physicians, but more importantly, providing them with a customized training and a well-equipped work environment so they can serve their roles in the best manner.

Rivers Integrated Care (RIC) is a primary care facility located in Phoenix Arizona. This clinic recently transitioned from an urgent care facility to an integrated primary care and emergency clinic. The goal of this transition is to become a patient-centered medical home and behavioral health facility. The clinic currently has a Behavioral Health Consultant, who is also the Site Administrator, Physician Assistant (PA) and a Primary Care Provider (PCP). The plan is to employ a full-time Psychiatrist to prescribe psychotic medication. Although employees of RIC consider this clinic a fully integrated facility. According to the Agency for Healthcare Research and Quality's (AHRQ) integration assessment tool, the clinic is partially integrated.

Health maintenance organization’s (HMOs) use of the primary care physician (PCP) as the “gatekeeper” initially had MCOs view restrictions as a negative approach to patients’ choices. However, some necessary steps have started to be implemented which reduce unnecessary utilization by enforcing some restrictions.

In N485 we learned about Care Coordination & Transition Management Correlation. Dr. Siemon asked us to describe how care coordination or care transition programs might be effective in improving the health outcomes of our project population.

Approximately three quarters (74.5 percent) of patients had fee-based plans for their health insurance, which included preferred provider organizations (PPOs) or other comprehensive plans. Health maintenance organization (HMO) plans and point-of-service (POS) plans accounted for 11.3 and 13.4 percent respectively. A very small portion of patients were enrolled in consumer-directed health plans (CDHPs) or high-deductible health plans

The proposed qualitative study will identify factors that contribute to pregnancy amongst youth-in-care. The intent of this research study is that the identified factors that contribute to pregnancy amongst youth-in-care will be known to social workers and foster parents to therefore better assist preventing pregnancy. The proposed research study will gather information from the youth-in-care themselves to positively assist in preventing pregnancy and addressing the unique needs and factors that contribute to pregnancy.

An integrated care pathway is a structured multidisciplinary synopsis of anticipated care, placed within a set timeline, to aid a patient with a specific condition or set of symptoms to move progressively through a clinical experience to positive outcomes, It is one of the main tools used to manage the quality in healthcare concerning the standardisation of care processes and therefore promotes organised and efficient patient care based on evidence based practice. (British Medical Journal, 1998). In this essay I aim to justify a patient pathway of care with reference to national and local agendas. I will analyse the assessment strategies utilised in the pathway from a bio-psycho-social perspective with reference to contemporary evidence and provide examples from clinical practice where assessment of the patient of the pathway impacts upon the care planning process.

Teamwork is vital in healthcare.  When all participants are engaged in a program, goals are successfully achieved. Being able to communicate and work collectively as a team requires an appreciation for each other’s area of practice.  Every team member has an important role and being acknowledged provides a sense of responsibility and accountability. Essentially, inter-professional collaboration helps ensure that the patient is getting care that is not only accessible but also comprehensive.  The plan of a patients’ care includes active participation by all health care professionals working interdependently in accordance to the patient’s preferences, values and beliefs. The health care team accomplishes the goal of meeting the patient’s medical needs by delivering evidence-based practice.   To deliver quality care, the patient should always be involved.

For successful collaboration to occur shared social mission and vision among internal and external stakeholders is crucial. According to Cramer, Atwood, and Stoner, (2006) for creating a long lasting community change, it is important that leaders are committed in providing the full support in developing the health care workers knowledge and skills. Leaders can achieve this by allocating resources for ongoing training to the workers. Shared values of patient-centered care needs to be clearly communicated via open forums and more avenues.