NURS FPX 6612 Assessment 4 Cost Saving Analysis

Name

Capella University

FPX6612: Health Care Models Used in Care Coordination

Instructor’s Name

March 2024

Cost Savings Analysis

As the senior care coordinator within our organization, evaluating the potential for care coordination initiatives to result in financial savings, increase patient outcomes, augment evidence-based data gathering, and raise the standard of community-based healthcare services is imperative. This assessment focuses on the impact of care coordination initiatives on financial performance, patient care, and organizational effectiveness, shedding light on the tangible benefits of investing in care coordination infrastructure and resources.

In order to guarantee the best possible patient outcomes and effective use of organizational resources, one of my responsibilities is to supervise care coordination initiatives. I will investigate the ways in which care coordination can result in financial savings, better results, more evidence-based data collecting, and ultimately higher-quality healthcare for the community in answer to my manager’s request. In order to complete this assignment, I will gather cost-saving information into a neat spreadsheet and summarize the main conclusions in an executive summary.

Cost-Saving Element Current Costs ($) Anticipated Savings ($)
Hospital Readmissions $500,000 $150,000
Medication Management $300,000 $100,000
Preventive Care $200,000 $75,000
Total Savings $325,000

 

Cost-saving information gathered from our hospital is presented in the table above. It draws attention to important areas where financial efficiencies brought about by care coordination actions have contributed to the organization’s overall cost savings. Preventive care services promotion, medication management optimization, and a decrease in hospital readmissions are all included in these savings.

Care Coordination Can be Cost Saving

By facilitating timely access to appropriate care and services, care coordination helps prevent costly complications and hospitalizations (Bravo et al., 2022). For example, proactive management of chronic conditions through regular monitoring, medication adherence support, and lifestyle interventions can prevent disease exacerbations, thereby reducing the need for costly emergency department visits or hospital admissions. This assumption is grounded in the literature, where studies have demonstrated that effective care coordination for chronic disease management leads to significant reductions in hospitalizations and associated costs (Bardhan et al., 2020).

Care coordination promotes efficient resource utilization by minimizing redundant or unnecessary healthcare services. Through comprehensive care planning and coordination among healthcare providers, duplicate tests, procedures, or consultations can be avoided, resulting in cost savings for both patients and healthcare systems. Care coordination also makes sure that patients receive the proper care in the correct environment, such as when it’s clinically appropriate to switch from inpatient to outpatient or home-based care (Iqbal, 2023). 

Furthermore, care coordination helps reduce healthcare spending by optimizing medication management and preventing adverse drug events. By coordinating medication reconciliation, adherence support, and medication therapy management services, care coordinators can identify and mitigate potential medication-related problems, such as drug interactions, non-adherence, or inappropriate prescribing. This proactive approach not only improves patient safety but also reduces the likelihood of hospital readmissions or emergency department visits due to medication-related issues (Bravo et al., 2022). Care coordination enhances care transitions and continuity of care, which can prevent fragmented care episodes and mitigate the risk of medical errors. 

Care Coordination Improves Health Consumerism and Outcome

Through effective communication, education, and shared decision-making, care coordinators help patients become informed consumers who understand their health conditions, treatment options, and care plans. By providing personalized support and guidance, care coordinators enable patients to make informed choices that align with their preferences, values, and goals (Vogus et al., 2020). This proactive approach fosters a sense of ownership and accountability among patients, leading to increased adherence to treatment regimens, healthier lifestyle behaviors, and better health outcomes. For example, by involving patients in care planning discussions and goal-setting exercises, care coordinators can empower them to take charge of their health and actively participate in their recovery journey, resulting in improved medication adherence, symptom management, and overall well-being.

Furthermore, care coordination enhances access to healthcare services and resources, which can positively impact health outcomes for patients. Care coordinators lower obstacles to patients’ access to necessary health services by arranging prompt referrals, visits, and follow-up care. This guarantees that patients receive the correct care at the right time (Bravo et al., 2022). This improved access to care can lead to early detection and management of health problems, preventing disease progression, complications, and hospitalizations. Additionally, care coordination helps address social determinants of health which can impact health outcomes. By connecting patients with community resources, support services, and care coordination efforts, care coordinators can mitigate these social factors and improve patients’ overall health and well-being (McMaughan et al., 2020). For instance, by partnering with community organizations and social service agencies, care coordinators can help patients access affordable housing, transportation assistance, and nutritional support programs, addressing underlying social determinants of health and promoting positive health outcomes.

Care Coordination Efforts Can Enhance the Collection of Evidence-Based Data

Primary care clinics serve as the main center for coordinating patient care throughout the healthcare continuum in the PCMH model (Wakefield et al., 2020). By implementing care coordination strategies within the PCMH framework, healthcare organizations can systematically collect and analyze data to inform evidence-based practice and quality improvement initiatives (Wakefield et al., 2020). For example, care coordinators embedded within PCMH practices can facilitate the systematic collection of patient data, including medical history, treatment outcomes, and patient-reported outcomes, through standardized assessment tools and electronic health record (EHR) systems. This comprehensive data collection process enables healthcare teams to identify gaps in care, measure performance metrics, and track patient progress over time, leading to more informed clinical decision-making and improved care quality.

Furthermore, care coordination efforts within the PCMH model promote interdisciplinary collaboration and information sharing among healthcare providers, leading to enhanced data exchange and integration. By fostering communication and teamwork among primary care providers, specialists, and community-based organizations, care coordinators facilitate the sharing of patient information, care plans, and best practices across different care settings and disciplines. This collaborative approach enables healthcare teams to access a more complete and holistic view of the patient’s health status, facilitating the identification of evidence-based interventions and care pathways tailored to the patient’s individual needs and preferences (Stockdale et al., 2021). For instance, care coordinators can coordinate multidisciplinary care conferences or case reviews where providers discuss complex patient cases, share insights, and develop consensus-based treatment plans based on the latest evidence and guidelines.

Moreover, care coordination efforts within the PCMH model leverage technology and data analytics tools to support evidence-based practice and quality improvement initiatives. By harnessing the power of EHR systems, clinical decision support tools, and population health management platforms, care coordinators can access real-time data on patient outcomes, resource utilization, and population health trends. This data-driven approach enables healthcare organizations to identify high-risk patients, stratify population health needs, and target interventions to improve health outcomes and reduce healthcare costs (Simpson et al., 2022). For example, care coordinators can use predictive analytics algorithms to identify patients at risk of hospital readmissions or adverse events, enabling proactive interventions such as care management, medication reconciliation, and patient education to mitigate risks and improve outcomes.

NURS FPX 6612 Assessment 4

Conclusion

The assessment has underscored the pivotal role of care coordination in driving positive outcomes across multiple dimensions of healthcare delivery. Through the strategic alignment of resources, effective communication, and collaboration among healthcare providers, care coordination has demonstrated its capacity to generate substantial cost savings, enhance patient outcomes, and improve the overall quality of care. By leveraging evidence-based practices and emerging healthcare models, organizations can further optimize their care coordination efforts, thereby fostering a culture of continuous improvement and innovation. 

 

References

Bardhan, I., Chen, H., & Karahanna, E. (2020). Connecting systems, data, and people: A multidisciplinary research roadmap for chronic disease management. MIS Quarterly: Management Information Systems, 44(1), 185–200. https://doi.org/10.25300/MISQ/2020/14644 

Bravo, F., Levi, R., Perakis, G., & Romero, G. (2022). Care coordination for healthcare referrals under a shared‐savings program. Production and Operations Management. https://doi.org/10.1111/poms.13830 

Iqbal, K. (2023). Resource optimization and cost reduction for healthcare using big data analytics. International Journal of Social Analytics, 8(1), 13–26. https://norislab.com/index.php/ijsa/article/view/4 

McMaughan, D. J., Oloruntoba, O., & Smith, M. L. (2020). Socioeconomic status and access to healthcare: Interrelated drivers for healthy aging. Frontiers in Public Health, 8(231). https://doi.org/10.3389/fpubh.2020.00231 

Simpson, K., Nham, W., Thariath, J., Schafer, H., Greenwood, M., Fetters, M. D., Serlin, D., Peterson, T., & Abir, M. (2022). How health systems facilitate patient-centered care and care coordination: A case series analysis to identify best practices. BMC Health Services Research, 22(1). https://doi.org/10.1186/s12913-022-08623-w 

Stockdale, S. E., Katz, M. L., Bergman, A. A., Zulman, D. M., Denietolis, A., & Chang, E. T. (2021). What do patient-centered medical home (PCMH) teams need to improve care for primary care patients with complex needs? Journal of General Internal Medicine. https://doi.org/10.1007/s11606-020-06563-x 

Vogus, T. J., Gallan, A., Rathert, C., Manstrly, D., & Strong, A. (2020). Whose experience is it anyway? Toward a constructive engagement of tensions in patient-centered health care. Journal of Service Management, ahead-of-print(ahead-of-print). https://doi.org/10.1108/josm-04-2020-0095 

Wakefield, B. J., Lampman, M. A., Paez, M. B., & Stewart, G. L. (2020). Care management and care coordination within a patient-centered medical home. JONA: The Journal of Nursing Administration, 50(11), 565–570. https://doi.org/10.1097/NNA.0000000000000938

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    NURS FPX 6610 Assessment 4

    Name Capella University FPX6610: Introduction

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    Name Capella University FPX6610: Introduction

    NURS FPX 6610 Assessment 2

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    NURS FPX 6610 Assessment 1

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