Description

This is a case study of a Provider Performing System (PPS) in New York State. New York is one of the first states to participate in the Delivery System Reform Incentive Payment (DSRIP) initiative, a new federal program that aims to improve healthcare quality for Medicaid patients. The PPS, Albany Medical Center, called on Accenture to help design a large-scale care coordination model to unite scores of healthcare providers and social service organizations across a five-county region. Accenture brought together an interdisciplinary team of consultants – including physicians and nurses – as well as specialists in healthcare strategy and collaborative technologies. The project team assessed processes currently in use by 20 key affiliates throughout the region, interviewed 80 staff members, and facilitated collaborative sessions to develop and agree on effective protocols. Six key themes emerged from this case study: 1) addressing behavioral health challenges, combined with lack of resources and fragmented care, is increasingly challenging; 2) inconsistent communications across the care continuum; 3) care continuum functions and processes are fragmented; 4) data systems were not often interfaced, resulting in limited data exchange; 5) there are limited options and extreme wait times for patients needing care; 6) social barriers often prevent patients from taking basic steps for proactive health maintenance and disease management.