According to the Centers for Medicare and Medicaid Services (CMS), an ACO is "an organization of health care providers that agrees to be accountable for the quality, cost, and overall care of Medicare beneficiaries who are enrolled in the traditional fee-for-service program who are assigned to it.(CMS, 2015).” ACO’s incorporated Chronic Care Management (CCM) Programs to help better oversee patients with multiple chronic conditions who see multiple specialists and allow for better continuity amongst providers caring for the same patient. ACO’s have yet to incorporate mental health services into your CCM program even though one in four primary care patients suffer from a mental disorder. Patients with mental illness, including but not limited …show more content…
also referred to as Duel-Diagnosis. Services were reorganized into interdisciplinary “continuity-of-care teams” that would essentially follow patients across all levels of their care from inpatient setting through to outpatient follow-up. These care teams incorporated services from disciplines which included nurses, psychologists, psychiatrists, and social workers.It is thought that “when continuity of care remains within a team, the clinicians can follow patients throughout their entire rehabilitation course both inpatient and outpatient(Lambert, 2012).” This allows for improved rapport between patient and providers, better compliance and cutting cost by avoiding any disconnect in care when patients would have previously required to re-establish with a different provider in the outpatient setting. The clinical question that I obtained was: Will incorporating mental health care into ACO’s improve patient outcomes and promote integration between mental health services/providers and the Primary Care Physician? The goal of my research is to find the potential benefits from the integration of mental health services into ACOs, and how healthcare organizations can support the implementation of integrated …show more content…
Continuity is maintained by providing patients with individual team business cards prior to discharge that provided the phone numbers and names of the treating clinicians. Similar to what is done in my current practice with each provider has a team of nurses who work under them directly. Patients are provided with direct contact information to their provider's nurse so that when patients call they can avoid prompts and can reach their nurse directly in real time. This process allows patient easy access to their providers and allows for improved treatment follow up with providers they have already developed a rapport with. Due to this method implementation at the VA in Dallas, “outpatient mental health follow-up visits increased 41% from 138,047 in 1996 to 194,746 in 1998. The percentage of all mental health costs expended on acute psychiatric inpatient care dropped by 10%. Patient satisfaction surveys and focus groups indicate that patients like not having to establish a relationship with a new set of clinicians each time they move through some level of the care
Never has it been more critical to provide high quality care in the hospital while being cost effective. The American Association of Colleges of Nursing (American Association of Colleges of Nursing [AACN], 2005) has created the Clinical Nurse Leader (CNL) role to introduce lateral integration of care for specified groups by creatively and intentionally using a variety of health care resources (AACN, 2005). The CNL’s purpose is to aid in various departments of the health care system including the psychiatric department. Although there is continuous tension between medical care and psychiatric care and choosing which is more important for a patient, the Clinical Nurse Leader is intended to bridge the gap between the two.
Changes in the current health care system can help prevent unsuccessful transitions of care. In order to move away from the “silos” of care, many institutions are starting to trend towards primary patient centered and interdisciplinary care. Having a team in charge of the care for a patient will allow more effective treatments and more communication between the different providers. While this is only within an inpatient setting and not necessarily transitions of care, the variety of clinicians involved in the care of a patient allows more information to be transmitted across different setting. The Society of Hospital Medicine developed Project BOOST to address issues with care transitions and to standardize a method for transition of care. Project
The current focus on new healthcare models is a reaction to long-standing concerns around quality, cost, and efficiency. Accountable Care Organizations model focus on integrated healthcare to promote accountability and improve outcomes for the health of a defined population. The goal of integrated healthcare is to ensure that patients, especially the chronically ill, get the right care at the right time, while avoiding unnecessary duplication of services and preventing medical errors (CMS, 2014). The following paper will analyze an ACO’s ability to change healthcare in the United States.
In 2003, leaders in North Carolina’s healthcare field realized they needed to bring about changes to the services they provided in their community’s mental healthcare programs (McLaughlin & McLauglin, 2008). The North Carolina Science to Service Project (NCS2S) was implemented to bring more coordinated, quality healthcare services to their mental health patients (McLaughlin & McLauglin, 2008). The goals of the project were to better match healthcare services to their mental healthcare patient population, apply evidenced-based practice guidelines in their mental health practice, ensure proper resources were allocated for the services, and begin state-wide training programs to their healthcare professionals (McLaughlin & McLauglin, 2008). This case study examines the integration of mental healthcare services into the community setting, the use of evidence-based practice guidelines, the effect on the stakeholders, and the role of healthcare professionals in implementing change.
Your long-term treatment does not stop in the facility. You need an after-care program to keep track of the progress you make in the outside world.
* Develops the annual department strategic plan presentation for the Mental Health department in conjunction with the Director of Mental Health.
In order to increase patient satisfaction by providing a more efficient method of continuity of care, Clark and the staff nurses proposed an innovative care delivery model that placed a Patient Care Facilitator (PCF) in charge of about 12 patients each (Clark, 2011). She further explains that each PCF will head 2 Registered Nurses (RN) and a Certified Nursing Assistant (CNA) for the same group of patients (Clark, 2011). Staffing plays a key role in continuity of care by having the same nurses staffed to the same group of patients with the PCF available 24/7.
The Affordable Care Act first provides a Marketplace where people can look for and compare private health plans, get answers to questions about health, get a break on costs and enroll in a health plan that meets their needs. The ACA also requires insurance plans to cover mental health benefits. Health insurance plans and Medicaid alternative benefit plans must include mental health and substance use disorder services.4 These plans must meet the health and substance use parity, which means coverage for mental health and substance abuse services generally cannot be more restrictive than those for medical and surgical...
Mental Health America Position Statement 71 Health Care Reform consists of all families and individuals having access to mental health services that meets their needs. This entails minimizing barriers, providing multiple referral and service pathways, redesigning services that are more culturally and linguistically competent and evidence-based,
According to the response of the State’s legislation, the change involves the four regional mental health hospitals that operate independently without common policies to regulate or synchronize their efforts. Although the legislation is evidence-based, it does not depend on local resources driven from within the mental health organizations inv...
Continuing budget cuts on mental health care create negative and detrimental impacts on society due to increased improper care for mentally ill, public violence, and overcrowding in jails and emergency rooms. Origins, of mental health as people know it today, began in 1908. The movement initiated was known as “mental hygiene”, which was defined as referring to all things preserving mental health, including maintaining harmonious relation with others, and to participate in constructive changes in one’s social and physical environment (Bertolote 1). As a result of the current spending cuts approaching mental health care, proper treatment has declined drastically. The expanse of improper care to mentally ill peoples has elevated harmful threats of heightened public violence to society.
...business. Also, the government needs to step up and pass legislation that puts more pressure on employers to include mental health coverage. Legislation pertaining to parity was a step forward, but an employer currently can simply drop mental health coverage to circumvent the laws. Finally, it is the duty of practitioners to serve the patients best interest, not that of the managed care company. Practitioners must put pressure on managed mental health care companies to place power back into the hands of the mental health professional who provide care for the patients daily. Patients are people not numbers.
Now I believe that transitional care interventions are very important, yet undervalued in the healthcare system. There are not enough protocols in place to ensure the implementation and the quality of the transitional care interventions. As future nurses, I should advocate for the importance of the transitional care interventions and promote the utilization of those interventions. Besides, I feel that a significant cause of preventable readmission is poor communication and coordination of care during transitions. Transitions between care settings are vulnerable periods for all patients, but especially older adults and those with multiply comorbidities. We need to develop an effective system to identify the patients who are at high risk for readmission, and make plans accordingly to ensure optimal communication and coordination of services to provide continuity of safe, timely, high-quality care during transitions. In order to achieve this goal, we need to improve the quality of patient and family education, coordination and arrangement of care in the post-acute care setting, and the communication among healthcare professionals involved in the patient’s care
My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.
...se of mental health services through health reform (2006). Many mental disorders can be treated effectively and people do recover (2010, 09 06). Many times mental disorders go untreated and it is very important that family and friends don’t let this go ignored and seek help for their loved ones.