Implementation of Care Management: An Analysis of Recent AHRQ Research

Andrada Tomoaia-Cotisel^{1

2

3}, Timothy W Farrell^{2

4}, Leif I Solberg⁵, Carolyn A Berry⁶, Neil S Calman⁷, Peter F Cronholm⁸, Katrina E Donahue⁹, David L Driscoll¹⁰, Diane Hauser⁷, Jeanne W McAllister¹¹, Sanjeev N Mehta¹², Robert J Reid¹³, Ming Tai-Seale¹⁴, Christopher G Wise¹⁵, Michael D Fetters¹⁶, Jodi Summers Holtrop¹⁷, Hector P Rodriguez¹⁸, Cherie P Brunker², Erin L McGinley¹⁹, Rachel L Day², Debra L Scammon², Michael I Harrison²⁰, Janice L Genevro²⁰, Robert A Gabbay¹², Michael K Magill²

Affiliations

¹ 1 The RAND Corporation, Boston, MA, USA.
² 2 University of Utah, Salt Lake City, UT, USA.
³ 3 London School of Hygiene and Tropical Medicine, London, UK.
⁴ 4 VA Geriatric Research, Education, and Clinical Center, Salt Lake City, UT, USA.
⁵ 5 HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
⁶ 6 New York University School of Medicine, New York, NY, USA.
⁷ 7 Institute for Family Health, New York, NY, USA.
⁸ 8 University of Pennsylvania, Philadelphia, PA, USA.
⁹ 9 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹⁰ 10 University of Alaska Anchorage, Anchorage, AK, USA.
¹¹ 11 Indiana University School of Medicine, Indianapolis, IN, USA.
¹² 12 Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
¹³ 13 Group Health Research Institute, Seattle, WA, USA.
¹⁴ 14 Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
¹⁵ 15 HeathPlus of Michigan, Flint, MI, USA.
¹⁶ 16 University of Michigan, Ann Arbor, MI, USA.
¹⁷ 17 University of Colorado Denver School of Medicine, Denver, CO, USA.
¹⁸ 18 University of California Berkeley, Berkeley, CA, USA.
¹⁹ 19 Penn State College of Medicine, Hershey, PA, USA.
²⁰ 20 Agency for Healthcare Research and Quality, Rockville, MD, USA.

PMID: 27789628
PMCID: PMC7177185
DOI: 10.1177/1077558716673459

Implementation of Care Management: An Analysis of Recent AHRQ Research

Andrada Tomoaia-Cotisel et al. Med Care Res Rev. 2018 Feb.

. 2018 Feb;75(1):46-65.

doi: 10.1177/1077558716673459. Epub 2016 Oct 23.

Authors

Affiliations

¹ 1 The RAND Corporation, Boston, MA, USA.
² 2 University of Utah, Salt Lake City, UT, USA.
³ 3 London School of Hygiene and Tropical Medicine, London, UK.
⁴ 4 VA Geriatric Research, Education, and Clinical Center, Salt Lake City, UT, USA.
⁵ 5 HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
⁶ 6 New York University School of Medicine, New York, NY, USA.
⁷ 7 Institute for Family Health, New York, NY, USA.
⁸ 8 University of Pennsylvania, Philadelphia, PA, USA.
⁹ 9 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹⁰ 10 University of Alaska Anchorage, Anchorage, AK, USA.
¹¹ 11 Indiana University School of Medicine, Indianapolis, IN, USA.
¹² 12 Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
¹³ 13 Group Health Research Institute, Seattle, WA, USA.
¹⁴ 14 Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
¹⁵ 15 HeathPlus of Michigan, Flint, MI, USA.
¹⁶ 16 University of Michigan, Ann Arbor, MI, USA.
¹⁷ 17 University of Colorado Denver School of Medicine, Denver, CO, USA.
¹⁸ 18 University of California Berkeley, Berkeley, CA, USA.
¹⁹ 19 Penn State College of Medicine, Hershey, PA, USA.
²⁰ 20 Agency for Healthcare Research and Quality, Rockville, MD, USA.

PMID: 27789628
PMCID: PMC7177185
DOI: 10.1177/1077558716673459

Abstract

Care management (CM) is a promising team-based, patient-centered approach "designed to assist patients and their support systems in managing medical conditions more effectively." As little is known about its implementation, this article describes CM implementation and associated lessons from 12 Agency for Healthcare Research and Quality-sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s). Successful implementation was characterized by resource availability (both monetary and nonmonetary), identifying as well as training employees with the right technical expertise and interpersonal skills, and embedding CM within practices. Our findings facilitate future context-specific implementation of CM within medical homes. They also inform the development of medical home recognition programs that anticipate and allow for contextual variation.

Keywords: PCMH; care coordination; care management; implementation; patient-centered medical home; primary care.

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Conflict of interest statement

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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References

1. Agency for Healthcare Research and Quality. (2011). Transforming primary care practice: Award recipients. Retrieved from http://www.ahrq.gov/research/findings/factsheets/primary/transpcaw/index...
1. Alexander JA, Paustian M, Wise CG, Green LA, Fetters MD, Mason M, & El Reda DK (2013). Assessment and measurement of patient-centered medical home implementation: The BCBSM experience. Annals of Family Medicine, 11(Suppl. 1), S74–S81. doi:10.1370/afm.1472 - DOI - PMC - PubMed
1. Berry CA, Mijanovich T, Albert S, Winther CH, Paul MM, Ryan MS, … Shih SC (2013). Patient-centered medical home among small urban practices serving low-income and disadvantaged patients. Annals of Family Medicine, 11(Suppl. 1), S82–S89. doi:10.1370/afm.1491 - DOI - PMC - PubMed
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1. Center for Health Care Strategies. (2007). Care management definition and framework. Retrieved from http://www.chcs.org/media/Care_Management_Framework.pdf

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Implementation of Care Management: An Analysis of Recent AHRQ Research

Affiliations

Implementation of Care Management: An Analysis of Recent AHRQ Research

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Research Materials