The Journal of Ambulatory Care Management This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

The Policy and Practice Legacy of the New Jersey Medicaid ACO Demonstration Project
The New Jersey Medicaid Accountable Care Organization (ACO) Demonstration was created with a unique combination of features regarding ACO geography, involvement of managed care organizations (MCOs), and shared savings parameters. Ultimately, the Demonstration did not lead to a sustainable accountable care financing model and shared savings were deemphasized. Instead, the ACOs evolved into community health coalitions focused on coordinating and enhancing a wide range of activities in partnership with state government, private health systems, community leaders, and MCOs. Currently, the state is developing policy parameters t...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

From the Editor
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: From the Editor Source Type: research

Accountable Care Program Implementation and Effects on Participating Health Care Systems in Washington State: A Conceptual Model
This study is based on key informant interviews with health care executives representing 5 large health systems that had entered into contracts with the Washington State Health Care Authority to provide accountable care network services under the State Innovation Model initiative. The purpose of this study was to explain effects of accountable care program (ACP) implementation on participating health care systems. Between January 2017 and May 2018, we conducted 2 rounds of semistructured interviews (n = 20). Results indicate the need to present a modified conceptual model aligned with ACP implementation in the current cont...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Medicaid Expansion and Hospitalization for Ambulatory Care–Sensitive Conditions Among Nonelderly Adults With Diabetes
Among nonelderly adults with diabetes, we compared hospitalizations for ambulatory care–sensitive conditions from 2013 (pre-Medicaid expansion) and 2014 (post-Medicaid expansion) for 13 expansion and 4 nonexpansion states using State Inpatient Databases. Medicaid expansion was associated with decreases in proportions of hospitalizations for chronic conditions (difference between 2014 and 2013 −0.17 percentage points in expansion and 0.37 in nonexpansion states, P = .04), specifically diabetes short-term complications (difference between 2014 and 2013 −0.05 percentage points in expansion and 0.21 in nonexpansion state...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Do Hospitalizations Disrupt Loyalty to Ambulatory Care Providers?
We sought to determine whether hospitalizations affect where patients seek ambulatory care. We conducted a retrospective cohort study of 569 adults who were attributed by a commercial payer to a large physician organization (PO) and hospitalized in 2015. Approximately half of the patients (55%) were admitted to the hospital affiliated with the PO; the rest were hospitalized elsewhere. Patients hospitalized elsewhere were significantly less likely to be seen by a PO provider in the 6 months posthospitalization than those hospitalized at the affiliated hospital (adjusted odds ratio = 0.29; 95% confidence interval = 0.17-0.48...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Chronic Condition Measurement Requires Engagement, Not Measurement Alone
This study uses data from Dartmouth-Hitchcock Medical Center and Kaiser-Permanente Colorado to evaluate providing PROMs directly to the primary care physician. We compared changes over time in urinary incontinence, falls, and mental and physical health between clinics providing augmented PROMs (N = 202 patients) and control clinics (N = 102 patients). Both the control and treatment groups exhibited improvements, but there was no significant difference in outcomes over time. These results suggest that measuring and printing out PROMs for primary care physicians will not result in better patient outcomes without physician cl...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Patient Dissatisfaction With Primary Care and Nonurgent Emergency Department Use
This study advances academic discussion by examining whether patient negative experiences during their encounter with a primary care physician (PCP) are associated with nonurgent ED use nationwide in the United States. This retrospective cohort study used data from the 2010-2011 Medical Expenditure Panel Survey. The independent measures were patient perceptions of PCPs' communication and care quality in 2010. The multivariate logit model was employed to analyze the nonurgent ED use as opposed to no ED use in 2011, after controlling for age, gender, race and ethnicity, rural/urban location, marital status, and education lev...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Developing Emerging Leaders to Support Team-Based Primary Care
Teams are increasingly used to deliver high-quality, accessible primary care, yet few leadership programs support the development of team-based care leadership capabilities. The 12-month Emerging Leaders program presents a prototype for how interdisciplinary training targeting frontline staff might be implemented. Emerging Leaders training included didactic content, mentorship, applied peer-to-peer learning, and personal leadership development components delivered in person and virtually. Attendance at training events was high. Nominators and Emerging Leaders noted improvements in knowledge, skills, and attitudes of progra...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Comment on “Connected Access”
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

“Connected Access”: Titrating the Right Dose of Access in the Digital Age
The concept of access to health care has been dominated by the visit-based paradigm. However, with the advent of telehealth, wearables, and mobile applications, much of the information that is exchanged at the time of the provider encounter can be transmitted virtually. This calls for a reconceptualization of access that is not so heavily reliant on “the visit.” We have proposed a concept of connected access that is “dose related,” based on the expertise of the provider and the channel through which a patient and a provider communicate. Particularly relevant to chronic care, the intensity of access can be titrated ...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Community Health Workers as Organizational Actors in Community Health Centers in 4 Gulf Coast States
This study demonstrates the value that CHWs can bring for clients and clinics as organizational actors. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Impact of Centralized Employment Structure on Community Health Work: A Qualitative Case Study of Community Health Workers and Key Leadership
While community health workers (CHWs) are employed in various arrangements, little is known about the association between organizational structure and CHW experiences. Seventeen in-depth interviews were conducted with CHWs, supervisors, and leadership employed in one centrally organized setting to investigate organizational structure and perceptions of CHW effectiveness. A model that hired employees but assigned them to various settings offered support and unique career advancement opportunities. Coordinated education, ongoing trainings, and persistent supervision were perceived to improve the accuracy of resource informat...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Common Attributes of Successful Care Manager Programs for High-Need, High-Cost Persons: A Cross-Case Analysis
Many programs use care managers to improve care coordination for high-need, high-cost patient populations. However, little is known about how programs integrate care managers into care delivery or the attributes shared by successful programs. We used a case study approach to examine the common attributes of 10 programs for high-need, high-cost individuals utilizing a longitudinal care manager that had achieved success in reducing cost, improving quality, or increasing patient satisfaction. Through interviews with program leaders and document review, we identified 10 common attributes of successful care manager programs, of...
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

From the Editor
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 26, 2019 Category: Emergency Medicine Tags: From the Editor Source Type: research

Threading the Needle Between Improving the Affordable Care Act and Medicare for All
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - May 29, 2019 Category: Emergency Medicine Tags: Moving Forward the Health Policy Agenda Source Type: research