In quest to find solution to growing nurse shortage and heightened attention to patient quality, many healthcare organizations leaders have turned to developing and testing new care delivery models. Innovative care models strive to improve patient quality and satisfaction by engaging nurses as well as other health care professionals in different roles across the continuum of care (Tenforde, Hefner, Kodish-Wachs, Iaccarino & Paganoni, 2017). Mobile integrated healthcare (MIH) is an emerging model in health care delivery models focused on closing care gaps through technological sophistication, physician-led interprofessional team to manage care transition and chronic care services on site in patient’s homes or work places. Furthermore, Patient Protection and affordable Care Act has made care more affordable and accessible for all Americans.
MIH is an innovative approach aimed at closing health gaps by utilizing core competencies of all professional staff in clinical settings available within the community providing health, post-acute care and EMS. In addition, MIH provides all- inclusive, physician-led, patient-centered population management solutions across care continuum, which involved integrating comprehensive care coordination, telehealth and telemedicine both in home as well as mobile care (Hirschman, Shaid, Bixby, Badolato, Barg, Byrnes & Naylor, 2017). Nevertheless, it helps in delivering appropriate care that is of high quality and cost effective is an imperative thus improving patient outcomes.
Tenforde, A. S., Hefner, J. E., Kodish-Wachs, J. E., Iaccarino, M. A., & Paganoni, S. (2017). Telehealth in physical medicine and rehabilitation: a narrative review. PM&R, 9(5), S51-S58.
Hirschman, K. B., Shaid, E., Bixby, M. B., Badolato, D. J., Barg, R., Byrnes, M. B. … & Naylor, M. D. (2017). Transitional care in the patient-centered medical home: Lessons in adaptation. The Journal for Healthcare Quality (JHQ), 39(2), 67-77.
Affordable Care Act made us think hard on our care delivery models. Greater emphasis was given to holistic approach that incorporated different discipline to achieve better patient outcome. Aim was to reduce healthcare cost and improve people’s life. Various models are floated to achieve the goal. Some of the models are Accountable Care Organizations (ACO), Medical/Health Homes, and Nurse- managed Health Clinics (NMHC), Chronic Care Delivery Model, Mobile Integrated Healthcare, Longitudinal High Risk Care, etc. (American Nurses Association, 2010).
ACO is gaining popularity. It is a basic team or collaboration between doctors, hospitals, specialist, other health care professional who take the responsibility of caring for their patients in a cost effective manner and providing quality care. Financial gains/bonuses are given if the ACO meets it target of quality (standards are set by HHS) and savings. “The ACO is a group of providers of services and suppliers that promotes accountability for a patient population and coordinates items and services under [Medicare] parts A and B, and encourages investment in infrastructure and redesigned care processes for high quality and efficient service delivery” (American Nurses Association, 2010, para 7). Now it is expanding beyond Medicare. This type of model is a unique ability to adjust to any type of payment method. They are able to take care of their patients across life span in various settings across continuum of care, figure out the budget beforehand and plan accordingly, help with resources, use evidence based treatment plans and cares, and have a detailed and reliable ways to measure performances. This model reduces hospital admission by stressing and implementing better preventive and wellness measures/primary care, reduces readmission via well-coordinated care approach, reduces costly hospital and ED admissions, and emphasis on total care (Haas, 2011, p.11). This model promises a better managed life for the patients and opens up a lot scope of practices for the nurses. Advanced practice nurses and the ambulatory nurses play a major role in providing for primary care of the patient and working towards the wellness and preventive care as emphasized in the ACA. A better coordinated care and triage is possible due to the electronic medical records and nurses reach out to the patient via telehealth.
American Nurses Association. (2010). New Care Delivery Models in Health System Reform: Opportunities for Nurses & their Patients. Nursing world. Retrieved from https://www.nursingworld.org/~4af0e8/globalassets/docs/ana/ethics/new-delivery-models—final—haney—6-9-10-1532.pdf
Haas, S. A. (2011). Health Reform Act: New Models of Care and Delivery Systems. ViewPoint: American Academy of Ambulatory Care Nursing (AAACN). Retrieved from https://eds-a-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=1&sid=d3b0da99-0ad5-4d7f-be7d-c2336008de51%40sdc-v-sessmgr01