Care Coordination Accountability Measures for Primary Care Practice

摘要

Care coordination has been recognized as an important aspect of high quality, patient-centered care, and was identified by the National Priorities Partnership as a priority area for improving health care delivery in the U.S. Much work remains to be done to elucidate how best to achieve coordinated care and how care coordination relates to important outcomes such as hospitalization rates, readmissions, mortality, quality of life, and patient satisfaction. Yet even as this evidence base is developing, efforts are underway across the health care system to evaluate and improve care coordination. Robust measures of care coordination processes are essential tools for generating evidence about care coordination and its outcomes; evaluating current practices; designing, implementing and assessing improvement activities; and supporting payment initiatives that target care coordination. This report presents measures selected systematically from the Care Coordination Measures Atlas (a compendium of existing measures of care Coordination) that are well-suited to primary care practice accountability and recognition purposes. It focuses on measures that are widely applicable and that reflect coordination as carried out by primary care practices rather than by other health care entities (e.g., hospitals, long-term care facilities, specialist providers). The report also includes measures that may be used to guide improvement efforts in response to the accountability measures. Measures were selected with four primary goals in mind: Ideally, measures included in the set should be comprehensive, covering all or most Atlas activity domains from the Atlas measurement framework. (For a list of these domain definitions, see Appendix A). Measures should balance comprehensiveness with feasibility. Measures should be valid and reliable. Measures should be useful for accountability and recognition purposes, as the first priority, though measurement gaps can be addressed by measures that are useful for quality improvement purposes.