Improving Cost Savings with Care Coordination: Executive Summary

Care coordination is the process of getting all the stakeholders that care for a patient to work in harmony as they provide healthcare services to the patient. In so doing, the patient’s preferences are known well in advance and errors of omission or commission are avoided. For instance, it would not be possible with care coordination for one provider to prescribe a medication and another different provider to also prescribe the same medication without knowing (Simmons, 2019; AHRQ, 2018). As a matter of fact, care coordination is the exact opposite of care fragmentation. The role of technology in care coordination in healthcare cannot be overemphasized. To this end, informatics knowledge in the context of health information management (HIM) is critical to facilitate care coordination. To be specific, it is the interoperability of electronic health record (EHR) systems that is the backbone of care coordination (McGonigle & Mastrian, 2017). Without this technological possibility, care coordination would be very difficult. The reason is simple – all medical records of patients are now stored electronically as per the law. To access them, therefore, someone from a different organization would need to have some means of connecting to the system of the organization that treated the patient first. Anecdotal evidence as well as scholarly evidence both point to the fact that care coordination saves costs for both the healthcare organization and the patient (Eastman, 2020; Simmons, 2019; Breckenridge et al., 2019). This is an executive summary of the cost saving analysis made with four cost elements in the context of care coordination.  Improving Cost Savings with Care Coordination Essay Example

How Care Coordination Can Generate Cost Savings

There are a number of ways in which care coordination can generate savings. For example, there are repetitive treatments and duplication of therapies that always occurs when there is care fragmentation and the providers seeing one patient are not communicating (Simmons, 2019). In this environment, the healthcare organizations waste resources by duplicating care and the patient spends money twice on the same procedures and treatments. This is money that can be saved if there is care coordination. There is also the risk that the patient can develop serious side effects of medications because two providers have each prescribed the same medication and the patient has taken both. The money used to treat the illness that results from this can also be saved by care coordination.

Lack of care coordination causes burnout and frustration among healthcare staff. This leads to high staff turnover with the requirement that organizations recruit replacement personnel. This costs the organization money which can be saved with care coordination. Last but not least is the cost of medical errors. According to Simmons (2019), costs related to preventable medical errors in the US alone total an average of USD 17 billion annually. This is money that can be saved if care coordination is embraced. My primary evidence-based sources of information include Breckenridge et al. (2019), AHRQ (2018), Simmons (2019), and Eastman (2020). The conclusions drawn are indeed substantiated by data from these sources as indicated above. The assumptions that underlie my analysis are that inflation remains constant and that natural calamities such as pandemics are not present.

Care Coordination and Improved Health Consumerism

Care coordination can of course promote improved health consumerism. It can also help produce positive health outcomes. This is possible from the fact that care coordination makes it easier for the patient to exercise autonomy as a bioethical principle. There will be knowledge shared among providers concerning the patient’s preferences and each provider will strive to conform to them. Harm will not be caused to the patient when medications are prescribed in repetition because of lack of sharing. In this atmosphere of care coordination, therefore, health consumerism will cease being a nightmare and become an enjoyable experience for patients. The lessening of preventable medical errors by care coordination, for instance, will result in a direct improvement of patient outcomes because there will be no harm caused to patients. The evidence that I have to substantiate my claims relates to the point of preventable medical errors made immediately above. Avoidable medical errors result in an average cost of about $17 billion every year (Simmons, 2019).

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Enhancement of Evidence-Based Data Collection by Care Coordination

Care coordination efforts can enhance the collection of evidence-based data through the following five ways:

1. Harmonization of dashboard metrics: With system interoperability and ease of inter-provider communication, data on the dashboards of the different organizations can be easily shared and compared. For instance, the data on patient falls as a dashboard metric.
2. Prevention of duplication of epidemiological data: With the patient known to all the providers taking care of them at the same time, there will be no duplication of epidemiological data. All the providers will report the same data for the same patient at the same time.
3. Better disease surveillance: There will be better surveillance of disease since the patient’s whereabouts will be known by all the providers taking care of them.
4. Better estimation of efficacy: It will be easier to collect efficacy data for interventions since the provider who starts it will hand over to the next provider because of communication facilitated by care coordination.
5. More accurate data collection on medication side effects: Providers will know with certainty what may be causing specific observed side effects. This is because they will be knowing exactly what the patient was given by the other provider and hat they themselves gave.

Care coordination will also improve care quality through the application of healthcare models such as Accountable Care Organizations or ACOs (CMS, 2020). ACOs are groups of providers who join to provide high-quality coordinated care to patients. They operate on the basic principle of care coordination to assure patients of care that is safe, timely, effective, efficient, equitable, and patient-centered.

Analysis of the Elements of Cost Saving with Care Coordination

The four cost saving elements that have been analyzed in the excel spreadsheet as an illustration are:

1. Treatment savings

Treatment costs that accrue as a result of care fragmentation amount to billions of dollars annually. This analysis estimates that each patient would be saving approximately $7,700 annually from unnecessary costs in repeated or duplicate treatment and tests (Eastman, 2020).

1. Savings on recruitment (human resource)

Recruitment to replace staff that have left out of inefficiencies caused by care fragmentation costs organizations a lot in fiscal resources. This estimate makes use of the figure provided by Simmons (2019). It is estimated that a savings of $100,000 would be made per employee if care fragmentation were to become the norm.

• Savings from medical error costs: Preventable medical errors result in malpractice suits, penalties and fines from regulatory bodies, and treatment costs to correct the errors. It is estimated that care coordination would save the organization upwards of $550,000 per patient per year with the prevention of these medical errors.

1. Opportunity cost: Lastly, while dealing with the consequences of care fragmentation or lack of care coordination, organizations lose on the potential benefits that they would get if that time was used to offer services to more patients. This is an opportunity cost that would be saved per patient at an estimated value of $250,000 annually.  
   

References

Agency for Healthcare Research and Quality [AHRQ] (2018). Care coordination. https://www.ahrq.gov/ncepcr/care/coordination.html#:~:text=Care%20coordination%20involves%20deliberately%20organizing,safer%20and%20more%20effective%20care

Breckenridge, E.D., Kite, B., Wells, R., & Sunbury, T.M. (2019). Effect of patient care coordination on hospital encounters and related costs. Population Health Management, 22(5), 406-414. http:dx.doi.org/10.1089/pop.2018.0176

Centers for Medicare & Medicaid Services [CMS] (February 11, 2020). Accountable Care Organizations (ACOs). https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index?redirect=/ACO/

Eastman, B. (March 17, 2020). Reduce costs with care coordination. Collective Medical. https://blog.collectivemedical.com/resources/thought-leadership/reduce-costs-with-care-coordination

McGonigle, D., & Mastrian, K.G. (2017). Nursing informatics and the foundation of knowledge, 4^th ed. Jones & Bartlett Learning.

Simmons, S. (September 6, 2019). 3 ways care coordination saves your healthcare organization money. Electronic Health Reporter. https://electronichealthreporter.com/3-ways-care-coordination-saves-your-healthcare-organization-money-2/

Prepare a spreadsheet of cost savings data showing efficiency gains attributable to care coordination over the course of one fiscal year, and report your key findings in an executive summary, 4–5 pages in length.

Information plays a fundamental role in health care. Providers such as physicians and hospitals create and process information as they deliver care to patients. However, managing that information and using it productively poses an ongoing challenge, particularly in light of the complexity of the U.S. health care sector, with its many diverse settings for care and types of providers and services. Health information technology (HIT) has the potential to considerably increase the productivity of the health sector by assisting providers in managing information. Furthermore, HIT can improve the quality of health care and, ultimately, the outcomes of that care for patients.

The use of HIT has been upheld as having remarkable promise in improving the efficiency, quality, cost-effectiveness, and safety of medical care delivery in our nation’s health care system. This assessment provides an opportunity for you to examine how utilizing HIT can positively affect the financial health of an organization, improve patient health, and create better health outcomes. Improving Cost Savings with Care Coordination Essay Example

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

• Competency 1: Apply care coordination models to improve the patient experience, promote population health, and reduce costs.

• • Describe ways in which care coordination can generate cost savings.
• Competency 2: Explain the relationship between care coordination and evidence-based data.

• • Describe ways in which care coordination efforts can enhance the collection of evidence-based data and improve quality through the application of an emerging health care model.
• Competency 3: Use health information technology to guide care coordination and organizational practice.

• • Explain how care coordination can promote improved health consumerism and effect positive health outcomes.
• Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.

• • Present cost savings data and information clearly and accurately.
  • Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.

Preparation

As the senior care coordinator in your organization, your manager has asked you to examine and report on how care coordination can generate cost savings, improve outcomes, enhance the collection of evidence-based data, and improve health care quality for the community. She would like you to compile cost savings data in a well-organized spreadsheet and present your key findings in an executive summary.  Improving Cost Savings with Care Coordination Essay Example

Requirements

Determine how care coordination can reduce costs. Compile your cost savings data in a spreadsheet, using Microsoft Excel. Your spreadsheet should contain at least four cost-saving elements. Identify the cost-saving element, current costs, and anticipated savings.

Then create an executive summary using the APA Style Paper Template]. Discuss your cost-saving elements and report key findings from your analysis.

Analyzing Cost Savings

The requirements outlined below correspond to the grading criteria in the scoring guide. Be sure that your analysis addresses each point, at a minimum. You may also want to read the Cost Savings Analysis Scoring Guide to better understand how each criterion will be assessed.

• Describe ways in which care coordination can generate cost savings.

• • What are your primary evidence-based sources of information?
  • Are your conclusions substantiated by the data?
  • What assumptions, if any, underlie your analysis?
• Explain how care coordination can promote improved health consumerism and effect positive health outcomes.

• • What evidence do you have to substantiate your claims?
• Describe at least five ways in which care coordination efforts can enhance the collection of evidence-based data and improve quality through the application of an emerging health care model.

• • Choose any emerging health care model.
• Present cost savings data and information clearly and accurately.
• Support main points, claims, and conclusions with relevant and credible evidence, correctly formatting citations and references using APA style.

Additional Requirements

Executive Summary Format and Length

Format your executive summary using APA style:

• Use the APA Style Paper Template [DOCX] provided. Be sure to include:

• • A title page and references page. An abstract is not required.
  • A running head on all pages.
  • Appropriate section headings.
• See also the APA Style Paper Tutorial [DOCX] to help you in writing and formatting your executive summary.
• Your summary should be 4–5 pages in length, not including the title page and references page.

Supporting Evidence

• Cite 4–5 sources of relevant and credible scholarly or professional evidence to support your cost savings analysis.
• Apply APA formatting to all in-text citations and references.

Submit both your spreadsheet and your executive summary.

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Cost Savings Analysis Scoring Guide

Improving Cost Savings with Care Coordination Essay Example