Harvard Case Study: Ledina Lushko Essay

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Case: Ledina Lushko

The case of Ledina Lushko, a patient enrolled in a Blue Cross and Blue Shield of Illinois individual plan, highlights many of the issues that have plagued the United States healthcare system for some time. As an insurance plan provider, BCBS of Illinois takes pride in the health outcomes of our members and has a responsibility to contribute positively to their care. The fractured, ineffective care Mrs. Lushko received is disappointing, however, this case provides strong support for a shift in focus towards managed care and specifically, the Accountable Care Organization structure. The following details several aspects of Mrs. Lushko’s experience and how her care could have been improved by enrollment in BCBS of
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Integrated EMR systems allow participating physicians to have real time access to patient charts, including test results, medical histories, and physician care notes. This provides organization throughout a patient's’ care and across different specialties improving the accuracy and efficiency of decision making. Integrated EMR systems as utilized in the ACO structure encourages physician communication and coordination in regards to testing, avoiding unnecessary frustration for the patient.

2. Issue: Uncoordinated Specialist Care

While Mrs. Lushko’s team of physicians included experienced, distinguished specialists, this team was built mostly by the efforts of the patients themselves, rather than the providers. After first contact with the Johnson Memorial Medical Center,Mrs. Lushko’s appointment with her designated primary care physician did not yield a beginning to a coordinated effort to provide her with medical care. Although Mrs. Lusko did see several specialist, the process of referral was often unorganized, leading to the patient meeting with several specialist within the same discipline on her own accord. This produced a fractured effort by the providers, often leading to conflicting opinions and recommendations.

Solution: Coordinated Team of Providers

Enrollment in a private ACO plan would have prevented this issue immediately and insured

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