Competing health care systems and complex patients: An inter-professional collaboration to improve outcomes and reduce health care costs

https://doi.org/10.1016/j.xjep.2017.01.002Get rights and content
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Abstract

Background

High-need, high-frequency patients overutilize acute care services, a pattern of behavior associated with many poor outcomes that disproportionately contributes to US healthcare costs.

Purpose

Our objective was to reduce healthcare costs while improving clinical outcomes through optimizing healthcare delivery and inter-professional collaboration for complex patients.

Method

To do so, we partnered with a competing health care system to address fragmentation in the patients' plans of care contributing to patterns of high utilization.

Discussion

Our collaborative approach was associated with a reduction in healthcare utilization and costs for this population, as well as an increase in operating margin.

Conclusion

Collaboration between neighboring competing health systems that share a select group of complex patients is an effective way to stabilize care, decrease health care system overutilization, improve healthcare delivery, and reduce the costs of associated care. Our intervention model provides a useful model for inter-organizational collaboration in healthcare.

Keywords

Cross continuum care collaboration
Competing health systems
Integrated care
High need patient
High frequency patient
Complex patient
Chronic patient
Emergency department
Individualized care
Decrease readmissions
Preventable hospitalization
Cost reduction
Root cause
Inter-professional team
Interorganizational team
Integrated behavioral health
Overuse
Overutilization
Super utilizers

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Funding: This work is supported by an Innovation Grant funded by Trinity Health. The funding organization(s) had no role in the design and conduct of the study; in the collection, analysis, and interpretation of the data; or in the preparation, review, or approval of the manuscript.

Conflicts of interest: The authors declare that they have no conflicts of interest.