Monday, April 29, 2019
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Driving Change: The Why and How of Advancing Person-Centered Outcome Measurement
Gretchen E. Alkema, Ph.D.
Vice President, Policy & Communications
Consumer's Vision of Success
- Ability to live life at the highest functional level possible with least intervention
- Needs met in a timely, organized, and convenient manner by competent providers
- Confidence in navigating care system by self or with support when needed
Sources of High-Cost Variation
Where Function Exists...
Functional Impairment Associated withHigh Medical Spending...
|Source: Anne Tumlinson Innovations analysis of the 2015 Medicare Current Beneficiary Survey. Data is limited to fee-for-service Medicare beneficiaries living in the community and excludes long-stay nursing home residents. Functional impairment in this display is measured at the "moderate" level. https://annetumlinsoninnovations.com/|
Particularly True for Those with 3+ Chronic Conditions
|Average Per Capita Medicare Spending, 2015|
|Source: Anne Tumlinson Innovations analysis of the 2015 Medicare Current Beneficiary Survey linked to Claims. Data is limited to fee-for-service Medicare beneficiaries living in the community; excludes long-stay nursing home residents. Functional impairment in this display is measured at the "moderate" level. https://annetumlinsoninnovations.com/|
Policy driving the change...
Business Case for Person-Centered Care
What Is Person-Centered Care?
A person's preferences and values guide all aspects of health care and support realistic health and life goals.
- Care Supported by One Team with the PERSON AT THE CENTER
- Personalized Care Plan and Regular Review of Goals
- Single Point of Contact
- Care Coordination with Continual Information Sharing
- Education and Training
- Ongoing Feedback for Care Improvement
NCQA Quality Framework
|FIGURE 3. Framework for Quality in Integrated Care|
|Source: NCQA. Integrated Care for People with Medicare and Medicaid: A Roadmap for Quality. 2013|
Better Care Playbook
Roadblocks & Paths Forward
- Old Paradigm
- What's the matter with you?
- Single provider focus & approach
- Provider action
- New Paradigm
- What matters to you?
- Customer service approach
- Consumer confidence & functional outcomes
The SCAN Foundation
- Our Vision: A society where older adults can access health and supportive services of their choosing to meet their needs.
- Our Mission: To advance a coordinated and easily navigated system of high-quality services for older adults that preserve dignity and independence.
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