Tuesday, February 9, 2016
Case Study: Designing More Affordable and Effective Health Care (Commonwealth Fund)
This case study is part of ongoing research by The Commonwealth Fund to track how health systems are transforming care delivery, particularly to meet the needs of high-need, high-cost patients and other vulnerable populations. The first publication in the series profiled the Penn Medicine Center for Health Care Innovation.
Spiraling health care costs in the U.S. place untenable burdens on an increasing share of Americans and divert money from education, research, and economic development. In 2010, Stanford University launched its Clinical Excellence Research Center (CERC) to develop new ways of delivering health care that might slow this spending growth. “What we want is affordable clinical excellence, and that’s what is distinctive about what we’re doing,” says Arnold Milstein, M.D., M.P.H., CERC’s director, who was recruited to lead CERC in part because of his success redesigning ambulatory care for medically fragile patients. The center identifies diseases, conditions, and health care services for which spending could be lowered by 30 percent or more for certain populations while also improving patient health and care experiences.
The new care designs are developed by multidisciplinary teams of postdoctoral fellows, including physicians, systems engineers, and social scientists. Fellows spend one to three years at CERC and receive intensive training in its research and care redesign methods. The teams are assigned ambitious goals — for instance, cutting in half national spending on treatment for chronic musculoskeletal pain. Because real-world demonstrations are a key to spreading new care models, CERC partners with health systems and health plans across the United States to try out and test their approaches. . .