The lack of integration among various silos and inadequate communication among medical providers cause delays in delivering appropriate health care services to our vulnerable patients’ population, mostly the uninsured and underinsured, resulting in poor health outcomes at a high cost. “A strategic plan provides a powerful roadmap to align and navigate organizational activities in pursuit of an impactful and inspiring future vision”.
As a part of my new role in the hospital system and with Managed Medicaid coming to our state, I am tasked to oversee the strategy to create a Chronic Disease Management Center/Clinic that will help to reduce chronic disease burden in the most efficient and cost-effective manner. This is a blend of transitions of care model and integrated model of care for patients with chronic diseases. This is in attempt to avert unnecessary hospitalizations and readmissions, support patients’ preferences and choices, and avoid duplication of services, thereby improving the quality of care while utilizing resources more effectively. I have not been able to rap my head around where or how to begin.
The challenge is, there are many stakeholders (primary care and specialists) who may not buy-in to this program because they already carry out some form of transition of care in their various clinics albeit rather inefficiently but will raise eyebrows since they will lose this segment of TOC revenue should this chronic disease clinic take off. Examples of existing TOC are: Heart Failure Clinic and COPD Gold among others.
Question: What are the critical steps/strategies required to creating and getting enough buy-in to implement a Chronic Disease Management Center/Clinic?
Your inputs are appreciated.