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.

Leveraged Primary Care: Lessons From the Trenches
To support primary care physicians (PCPs) in managing populations of patients requires a reengineering of PCP practices, and a new, disruptive model of care management, with the seamless integration of the 2. That is our conclusion, having watched 7 Accountable Care Organizations (ACOs) with direct employer contracts provide care to employed populations over a period of 6 years. We have seen dramatic improvement in outcomes when an ACO provides the needed resources, tears down the silos, and interweaves care management with PCP practices. That is leveraged primary care. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Commentary on “Quality Measurement for Consumers: An Idea Whose Time Should Pass”
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Permanent Interests Versus Paying for Better Outcomes: Two of the 10 Lessons I Learned Over the Past 30 Years Researching the Connections Between Payment and Health Care Quality
In the wake of the election of Donald Trump, I resigned from my research work. I decided to become politically involved and since I am a health care professional, in June 2018, I started a bipartisan political consulting firm, Ask Nurses and Doctors (AND; www.asknursesdoctors.com). This start-up is focused on electing candidates or incumbents committed to health care reform. There are 2 approaches to universal coverage—either the Affordable Care Act or Medicare for All. To implement either approach, there are 10 lessons from my 30 years of research that may be useful to enact universal coverage. (Source: The Journal of A...
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Commentary on “Improving Quality Measurement: Design Principles for Quality Measures”
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 Category: Emergency Medicine Tags: Original Articles Source Type: research

Improving Quality Measurement: Design Principles for Quality Measures
This article discusses some of these problems and then lays out some principles and procedures that should be used in the development and combination of quality measures. Many of the problems with existing quality measures would have been avoided had these principles been applied as they were developed. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - February 19, 2020 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 - February 19, 2020 Category: Emergency Medicine Tags: From the Editor Source Type: research

A Closer Examination of the Patient Experience in the Ambulatory Space: A Retrospective Qualitative Comparison of Primary Care With Specialty Care Experiences
This qualitative study explores key patient experience impressions responsible for driving quality. Differences between primary and specialty care patient perspectives were analyzed using a mixed-methods design in high-, median-, and low-quality performing practices. We found that primary care patients highly value provider listening, time spent with provider, and consistent and effective coordination of care. Specialty care patients were found to highly value provider clinical skill acumen/outcomes, being kept informed with timely updates and care instructions, and a stress- and pain-free experience. We conclude that diff...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

The Effects of Session Standardization and Template Optimization on Improving Access to High-Demand Pediatric Subspecialty Care
This article describes the experiences of a large children's hospital after implementation of clinic session standardization and template optimization. Outpatient specialty clinic sessions were standardized to 4-hour periods, and all unfilled complex appointment slots were made available for any appointment type within 72 hours of the clinic date. Three high-demand outpatient clinical services achieved increased aggregate potential and completed outpatient appointments over a 2-year period. These improvements were mostly due to an increase in providers and were not always coupled to shorter patient lag times. (Source: The ...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Closing the Loop on Electronic Referrals: A Quality Improvement Initiative Using the Care Coordination Model
Primary care providers refer nearly one-third of their patients to specialty care services. Despite provider recommendations, approximately 1 in 4 referrals are never completed. Incomplete referral rates are higher among vulnerable and medically underserved individuals. Sixty-seven percent of federally qualified community health centers report difficulty obtaining specialty care appointments and incomplete referral rates as high as 73%. Effective electronic referral processes can improve health outcomes, reduce waste, and mitigate risks. Using the Care Coordination Model as its framework, this quality improvement initiativ...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Talk to PAPA: A Systematic Review of Patient/Participant (PAPA) Feedback on Interactions With Community Health Workers Using a Depth Analysis Approach
Because of their shared backgrounds, community health workers' (CHWs) care of patients/program participants (PAPAs) is assumed to be acceptable, and often not evaluated empirically. Using PRISMA guidelines, we reviewed 9560 articles from 5 databases, selected 37 articles for full-text review, and developed a 5-dimensional depth analysis (focus, context, meaning, range, and voices) to characterize quality/quantity of PAPA feedback. Depth analyses clarified a spectrum of PAPA responses from extremely positive to ambivalence to outright distrust and frustration with perceived CHW limitations. Designing evaluations with 5-dime...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

More Than Health Care: The Value of Addressing Health, Education, and Social Service Needs Together Through Community Health Centers
Research on social determinants of health shows that factors outside of medical care including environment, education, and income also affect health. Some community health centers seek to address these by providing additional nonmedical services. Community health centers can find it difficult to justify these costs when the benefit is unclear. This review highlights studies on services like those the community health center Mary's Center provides through its Social Change Model, offering health, education, and social services in the Washington, District of Columbia metropolitan area. The review finds that most studies repo...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Understanding Why Urban, Low-Income Patients Miss Primary Care Appointments: Insights From Qualitative Interviews of West Philadelphians
Missed primary care appointments occur frequently among urban, low-income patients—some of the costliest and sickest patients. We conducted semi-structured interviews with 43 patients who reside in West Philadelphia (100% insured by Medicaid, 95% were non-Hispanic African Americans, and 47.1 years old on average) to identify why recent primary care appointments were or might have been missed. Existing transportation options, including public transportation, were considered unreliable and alternative options too costly. In addition, we discovered poor health, family obligations, and work requirements prevented appointment...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

From Volume- to Value-Based Payment System in Washington State Federally Qualified Health Centers: Innovation for Vulnerable Populations
The reimbursement system at 16 Federally Qualified Health Centers in Washington State transformed to a per-member-per-month model with a prospective adjustment for quality performance. The results of this qualitative study suggest that 3 to 5 years would be required to achieve significant progress in the Triple Aim goals of the initiative and also demonstrate that Federally Qualified Health Centers are potentially more advanced in their readiness to offer value-based care. By providing positive financial incentives without downside risk, the state is stimulating replicable models of care, and in longer term such reforms ma...
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

It's Time for a New Approach to ACOs
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Accountable Care Organizations in Medicaid
No abstract available (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - November 27, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research