Health care reform's requirements and insurance payers' demands are transforming the way that health care is delivered and providers are paid. We are moving from payment on a fee-for-service basis focused on volume to payment for patient outcomes based on quality and cost. To reduce costs and improve the health of populations, the new health care environment calls for a focus on wellness rather than treating illness. Health care delivery systems must be clinically integrated to be successful in this new environment and to provide the best possible care.
One definition of clinical integration is "a structured collaboration among physicians and hospitals to develop an active and ongoing program designed to improve the quality and efficiency of heath care" (Advocate Health Care). A clinically integrated organization is designed to remove barriers to the coordination of patient care. Clinical integration is a relatively new concept that is being employed more regularly across the country.
As a community of physicians, Integrated Care Partners defines performance objectives, quality standards and evidence-based medicine protocols; forges partnerships with health plans, employers and providers; and establishes requirements for participation – all with the ultimate goal of providing high-quality, coordinated patient care and improving the overall health of populations.
Integrated Care Partners is not an employed practice model, a program run by hospitals, physician employment or a practice-management service. It includes private-practice physicians as well as physicians employed by or associated with Hartford HealthCare. There is no enrollment fee.
Physicians who are committed to engaging in an active program of clinical integration are invited to join Integrated Care Partners. The invitation extends to Hartford HealthCare-associated physicians, employed and in private practice, as well as community-based physicians who are not part of a Hartford HealthCare member organization.
To improve the health and healing of the people and communities we serve.
To be nationally respected for excellence in patient care and most trusted for personalized coordinated care.
Hartford HealthCare's vision of excellence and leadership is driven by its core values, which are shared by all members of Hartford HealthCare.
Our goals are to:
- Bring together all Hartford HealthCare physicians, both independent and employed.
- Enhance already-established standards of patient-centered care and excellence.
- Measure our success in meeting those standards and performing in the top decile.
- Focus on improving the health of the populations we serve.
- Shift the contracting focus from fee-for-service to a value-driven compensation model, rewarding high-quality, efficient care rather than volume.
- Provide analytics and tools for physicians to improve quality and to succeed under value-based contracts.
- Deliver value to consumers and employers.
- Operate transparently and share data.
- Forge partnerships with health plans, employers and providers.
Integrated Care Partners seeks to:
- Be physician-led, patient-centered, quality-based and value-focused.
- Practice using evidence-based medicine driven by shared data.
- Deliver value for consumers and employers.
- Forge partnerships with health plans, employers and providers.
Align incentives so everyone is working together toward the same goals.
- Establish evidence-based standards of care and hold members accountable to meet those standards.
- Provide physicians with tools to capture and analyze performance data.
- Identify opportunities for improvement and support practices in making those improvements.
- Provide case-management support to practices for helping patients participate in meeting standards of care.
- Contract for value-based compensation that rewards high-quality, efficient practice performance.
- Rewards for high quality and initiatives.
- Care-management support.
- Capabilities to measure and monitor quality and performance.
- Access to contracts and patients as preferred providers.
- Tools to help drive better outcomes and succeed in the new world of payment for value rather than fee for service.
- Financial support for IT investments.
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Patients benefit from the use of established standards of care in many ways, including:
- One point of focus (the patient).
- One source of patient information (integrated care record).
- One standard of quality (defined by collaborating clinicians).
- One population (everyone is focused on care improvement).
Accomplishments (FY 2015)
- To provide more complete, holistic patient care, began integrating behavioral health services into primary care to assist in diagnosis and assessment of patients’ behavioral health problems.
- Expanded community care management team to more than 30 members (nurses, social workers, health coaches) to assist physicians and practices in improving outcomes for patients with chronic conditions. Team members are nationally certified in managing chronic diseases.
- Led the system-wide implementation of RightCare, a software platform used in hospital admissions to identify patients at high risk for readmission or complications from their illnesses. RightCare, proven to reduce readmissions and improve patient outcomes, assists in better care coordination and patient transition to post-acute care, including skilled nursing, home care or rehabilitation services. RightCare is in place at HHC hospitals and is connected to several skilled-nursing facilities.
- Led establishment of congestive heart failure clinics at Hartford Hospital, Windham Hospital and MidState Hospital, using the pilot program at The Hospital of Central Connecticut as an example, to reduce patient readmissions and improve patients’ quality of life through education and enhanced patient engagement.
- Led establishment of a system-wide preferred provider network of 38 skilled-nursing facilities across the state to ensure patients transition from HHC hospitals to facilities that meet specific quality standards.
- Established Hartford HealthCare Employee Wellness Program to improve employee access to and education about preventive care to enhance overall employee well-being.
- Implemented pilot primary care clinic for Hartford HealthCare employees based on team-delivered healthcare, including physicians, a behavioral health specialist and a health coach, to use as a model for other primary care practices.
- In partnership with the University of Connecticut School of Pharmacy, began integrating medication management into primary care to improve patient outcomes and reduce readmissions.