This project is in keeping with the national agenda of the "triple aim," an enhanced experience for the individual, improved care for the entire patient population, and reduced costs for all. One of the elements envisioned as part of the Affordable Care Act, the health care reform package advanced by President Obama, is bundled payments where the provider team is paid a set amount for the patient’s care experience during the hospital stay and for a period thereafter.
At Kent, this new way of caring for patients with congestive heart failure will give us some invaluable experience as we transition into the new era of payment and health care delivery reform. Under the leadership of Chester Hedgepeth, MD, Chief of Cardiology at Care New England, this pilot program will involve a multidisciplinary team representing virtually every medical, ancillary, home health, nursing home and social support service. This entire team came together in preparing our CMS application to ponder how optimal care could be delivered to the CHF patient.
For example, one of the least addressed aspects of the CHF patient’s needs is the area of behavioral and mental health. Our team approach considered this vital dimension and included it in our care model.
Going well beyond the basic medical needs, we also considered the emotional, educational and social needs of the patient and his or her family. It truly takes a village to provide this type of comprehensive care, but in order to assure coordination, our program puts a care manager in the center of the team as the patient’s primary point of contact.
Through such high level collaboration and coordination, it is hoped that the period of hospitalization can be shortened and the possibility of re-hospitalization lessened.
"We are extremely excited to have been chosen to participate in this program which supports the shared vision of Medicare and Care New England to improve the care of patients with congestive heart failure," said Dr. Hedgepeth. "This innovative program aligns perfectly with cardiology care delivery models being developed at Care New England, which will serve to bring together collaborative teams of experts to focus care on this specific population of high risk patients. Ultimately, we expect the impact of this new program to be an overall reduction in readmission rates related to congestive heart failure."
This is the potential—and the promise—of helping to transform the future of health care for this community.