Care groups and care coordination

Improving the quality of care for patients is critically important for their health and safety as well as for the primary care practice’s success and sustainability. One very important aspect of providing that level of care is care coordination, often enabled through structured care groups. The interoperability of the practice’s technology is also integral to coordination and communication between patients and providers.

Care coordination means sharing information between all participants involved in a patient’s care, with the aim of achieving more effective care, in a safer manner. This type of communication ensures that the patient is getting the right care at the right time and that the primary care physician is able to use that information to offer appropriate and effective care to the patient.

When care is not properly coordinated, the patient can suffer the consequences. Tests and diagnostic procedures can be unnecessarily duplicated. Critical information may not be shared between the specialty provider and the primary care provider in a timely manner. Prescriptions that are contra-indicated could jeopardize the health and well-being of the patient.

A key strategy for improving the efficiency and effectiveness of healthcare, care coordination that is well designed and targeted can improve outcomes for everyone. That includes patients, third-party payers, and independent physicians.

One of the main goals of care coordination is meeting the patient’s needs and preferences as the physicians deliver the highest quality, high-value healthcare. To do this, these needs and preferences must be understood and communicated to the right people as they need it, so they can deliver safe and appropriate care to that patient.

Broad care coordination approaches can include:

• Medication management
• Teamwork within the clinical setting
• Care management
• A patient-centered medical home (PCMH)
• Healthcare technology, including electronic health records (EHRs)

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Interoperability is a key factor in care coordination. A collaborative EHR system enables the primary care provider to compare data with other providers with up-to-date, on-demand access to patient information from special providers or laboratories within the network.

Several additional elements are also involved in the successful delivery of coordinated care, including:

• Quality communications and effective care plan transitions
• Clear and simple information for the patient to understand and become involved in their own care
• Easy access to healthcare services and providers
• A focus on the total needs of the patient.

The proper infrastructure and resources are vital for physicians to successfully coordinate care to benefit the patient and the practice. Supported synchronized efforts, collaboration, and communication among all providers and specialists are key. To this end, independent primary care groups can serve to improve patient care by preserving the autonomy of independent practices with the resources that are important for success in value-based contracting, in particular.

In the current healthcare environment, which is constantly evolving, the provider’s success will require investments in health information technology as well as skilled staff and leadership. Care groups offer the scale that can make these investments while also negotiating higher payment rates and offering independent physicians a more secure and stable viability.