Accelerating Best Practices in Peer Support Around the World

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11.30.17

Impact Of Health Care Delivery System Innovations On Total Cost Of Care

Health Aff (Millwood). 2017 Mar 1;36(3):509-515. [Pubmed Abstract]

Smith KW, Bir A, Freeman NL, Koethe BC, Cohen J, Day TJ

Abstract
Using delivery system innovations to advance health care reform continues to be of widespread interest. However, it is difficult to generalize about the success of specific types of innovations, since they have been examined in only a few studies. To gain a broader perspective, we analyzed the results of forty-three ambulatory care programs funded by the first round of the Center for Medicare and Medicaid Innovation’s Health Care Innovations Awards. The innovations’ impacts on total cost of care were estimated by independent evaluators using multivariable difference-in-differences models. Through the first two years, most of the innovations did not show a significant effect on total cost of care. Using meta-regression, we assessed the effects on costs of five common components of these innovations. Innovations that used health information…

11.30.17

Innovative Home Visit Models Associated With Reductions In Costs, Hospitalizations, And Emergency Department Use

Health Aff (Millwood). 2017 Mar 1;36(3):425-432. [Pubmed Abstract]

Ruiz S, Snyder LP, Rotondo C, Cross-Barnet C, Colligan EM, Giuriceo K

Abstract
While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits. Two models achieved significant reductions in Medicare expenditures, and three models reduced utilization in the form of emergency department visits, hospitalizations, or…

11.30.17

Documenting CHW Roles in Primary Care: Contributions to Evidence-Based Integration Into Health Care Teams, 2015

J Ambul Care Manage. 2017 Oct/Dec;40(4):305-315. [Pubmed Abstract]

Reinschmidt KM, Ingram M, Morales S, Sabo SJ, Blackburn J, Murrieta L, David C, Carvajal SC

Abstract
The Patient Protection and Affordable Care Act provided community health workers (CHWs) with new opportunities, and current efforts develop evidence-based guidelines for CHW integration into clinical teams. This qualitative study documents CHW roles and activities in 3 federally qualified health care centers in southern Arizona. Community health worker clinical roles, activities, and integration varied by health center and were in flux. Integration included complementary roles, scheduled and everyday communications with team members, and documentation in the electronic health records. These findings contribute to evidence-based guidelines for CHW integration into clinical teams that are critical to maximizing CHW contributions to patient health improvements.

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