A study of hypertensive patients found that those who actively participated with physicians in decisions and treatment were more effective in monitoring and controlling their blood pressure, took more clinical responsibility, and used provider resources more effectively.4 Nurse triage call centers equipped with computerized protocols bring access on demand to patients as well as an efficient tool for the information and decision-making phases of care. Clearly, triage is a growing, efficient point of patient access for patient groups for whom providers and insurers are at financial risk. Midlevel providers are another efficient care process redesign strategy that also reduces costs and enhances revenue. A survey of 26 integrated delivery systems showed that all are expanding the roles of advanced practice nurses and feel that insurers should relax constraints on their roles. An episode of care may actually look different.
Patients peruse their charts and share common concerns.
This is not business as usual. Initial data indicates that Cooperative Care patients have fewer ER and clinic visits, reduced hospital admissions, lengths of stay, and higher immunization rates. In addition, fewer of these patients are leaving the plan. Matching Services With Payer Mix Reviewing budgets in relation to payer mix can help identify optimal care redesign strategies. Best Care Medical Center is a fictionalized multispecialty group of 175 physicians drawn from actual clients.