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CHALLENGES IN CARE COORDINATION

CHALLENGES IN CARE COORDINATION FINDINGS FROM REPORT ON EXAMINATION OF HEALTH CARE COST TRENDS AND COST DRIVERS PURSUANT TO G.L. c. 118G, § 6½(b) June 30, 2011 OFFICE OF ATTORNEY GENERAL MARTHA COAKLEY ONE ASHBURTON PLACE • BOSTON, MA 02108. What is care coordination?. AGO Review.

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CHALLENGES IN CARE COORDINATION

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  1. CHALLENGES IN CARE COORDINATION FINDINGS FROM REPORT ON EXAMINATION OF HEALTH CARE COST TRENDS AND COST DRIVERS PURSUANT TO G.L. c. 118G, § 6½(b) June 30, 2011 OFFICE OF ATTORNEY GENERAL MARTHA COAKLEY ONE ASHBURTON PLACE • BOSTON, MA 02108

  2. What is care coordination?

  3. AGO Review How do Massachusetts provider groups provide coordinated care? • Study of 16 provider organizations

  4. Health care provider organizations designed around primary care can coordinate care effectively • through a variety of organizational models; • provided they have appropriate data and resources; and • while global payments may encourage care coordination, they pose significant challenges.

  5. Provider Group Models

  6. We found: • A variety of provider organizations can deliver high-quality coordinated care, regardless of whether they are physician or hospital-based, corporately integrated or of larger size.

  7. Care Coordination Requires:

  8. Data • The ability of the market to encourage coordinated care and to measure system-wide performance is hampered by the lack of transparent and reliable information

  9. Dr. John Freedman

  10. Importance of Data • Claims data for providers • Analysis of claims data for providers and policy makers • Utilization data • Site of service data • Practice pattern variation data • Quality data

  11. Key Takeaways • No one type of provider organization is better positioned to deliver coordinated care • Tools are needed: • Primary care is critical foundation • Resources for infrastructure and management • Importance of data: • For providers • To measure system change

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