Implementation of Care Management: An Analysis of Recent AHRQ Research

Andrada Tomoaia-Cotisel; Timothy W Farrell; Leif I Solberg; Carolyn A Berry; Neil S Calman; Peter F Cronholm; Katrina E Donahue; David L Driscoll; Diane Hauser; Jeanne W McAllister; Sanjeev N Mehta; Robert J Reid; Ming Tai-Seale; Christopher G Wise; Michael D Fetters; Jodi Summers Holtrop; Hector P Rodriguez; Cherie P Brunker; Erin L McGinley; Rachel L Day; Debra L Scammon; Michael I Harrison; Janice L Genevro; Robert A Gabbay; Michael K Magill

doi:10.1177/1077558716673459

Implementation of Care Management: An Analysis of Recent AHRQ Research

Med Care Res Rev. 2018 Feb;75(1):46-65. doi: 10.1177/1077558716673459. Epub 2016 Oct 23.

Authors

Andrada Tomoaia-Cotisel^{1

2

3}, Timothy W Farrell^{2

4}, Leif I Solberg⁵, Carolyn A Berry⁶, Neil S Calman⁷, Peter F Cronholm⁸, Katrina E Donahue⁹, David L Driscoll¹⁰, Diane Hauser⁷, Jeanne W McAllister¹¹, Sanjeev N Mehta¹², Robert J Reid¹³, Ming Tai-Seale¹⁴, Christopher G Wise¹⁵, Michael D Fetters¹⁶, Jodi Summers Holtrop¹⁷, Hector P Rodriguez¹⁸, Cherie P Brunker², Erin L McGinley¹⁹, Rachel L Day², Debra L Scammon², Michael I Harrison²⁰, Janice L Genevro²⁰, Robert A Gabbay¹², Michael K Magill²

Affiliations

¹ 1 The RAND Corporation, Boston, MA, USA.
² 2 University of Utah, Salt Lake City, UT, USA.
³ 3 London School of Hygiene and Tropical Medicine, London, UK.
⁴ 4 VA Geriatric Research, Education, and Clinical Center, Salt Lake City, UT, USA.
⁵ 5 HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
⁶ 6 New York University School of Medicine, New York, NY, USA.
⁷ 7 Institute for Family Health, New York, NY, USA.
⁸ 8 University of Pennsylvania, Philadelphia, PA, USA.
⁹ 9 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
¹⁰ 10 University of Alaska Anchorage, Anchorage, AK, USA.
¹¹ 11 Indiana University School of Medicine, Indianapolis, IN, USA.
¹² 12 Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
¹³ 13 Group Health Research Institute, Seattle, WA, USA.
¹⁴ 14 Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
¹⁵ 15 HeathPlus of Michigan, Flint, MI, USA.
¹⁶ 16 University of Michigan, Ann Arbor, MI, USA.
¹⁷ 17 University of Colorado Denver School of Medicine, Denver, CO, USA.
¹⁸ 18 University of California Berkeley, Berkeley, CA, USA.
¹⁹ 19 Penn State College of Medicine, Hershey, PA, USA.
²⁰ 20 Agency for Healthcare Research and Quality, Rockville, MD, USA.

Abstract

Care management (CM) is a promising team-based, patient-centered approach "designed to assist patients and their support systems in managing medical conditions more effectively." As little is known about its implementation, this article describes CM implementation and associated lessons from 12 Agency for Healthcare Research and Quality-sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s). Successful implementation was characterized by resource availability (both monetary and nonmonetary), identifying as well as training employees with the right technical expertise and interpersonal skills, and embedding CM within practices. Our findings facilitate future context-specific implementation of CM within medical homes. They also inform the development of medical home recognition programs that anticipate and allow for contextual variation.

Keywords: PCMH; care coordination; care management; implementation; patient-centered medical home; primary care.

Publication types

Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

MeSH terms

Continuity of Patient Care / organization & administration*
Health Plan Implementation / methods*
Humans
Patient-Centered Care / organization & administration*
Primary Health Care / organization & administration*
United States
United States Agency for Healthcare Research and Quality*

Abstract

Publication types

MeSH terms

Grants and funding