Innovative Healthcare Delivery Models

The panelists identify some of the drivers of the new healthcare delivery models, discuss some of the recent innovations in healthcare delivery, and also express concern that new delivery models may lead to a loss of coordination of care.

“One driver of change on the delivery side is value-based purchasing,” declares Ateev Mehrotra, MD, MPH, associate professor of health care policy and medicine at Harvard Medical School, Boston, and a hospitalist at Beth Israel Deaconess Medical Center, Medfield, Massachusetts. Many small primary care providers lack resources and have limited staff, says Dr Mehrotra, but they need to handle “the capital costs and hardware that are necessary for implementing the electronic health record,” which is essential to quality measurement and reporting initiatives.

New innovations in healthcare delivery include retail clinics, urgent care centers, electronic visits, coaching navigators, and even nurse practitioners who come directly to a patient’s home. All of this is “really exciting for patients, because they have a lot more choices available to them,” comments Dr Mehrotra. If a new delivery model is readily available and convenient, he believes the result will be greater utilization and increased healthcare spending.

the panelists admit that even if a new healthcare delivery model creates faster, more efficient care that is also of good quality, not every plan will reimburse for these services. Arthur Vercillo, MD, FACS, a surgeon and regional president of Excellus Blue Cross Blue Shield, is in favor of convenient local care. His concern, though, is that some patients may visit different clinics, urgent care centers, and drugstores, jeopardizing coordination of care, and “I really think we want to head toward delivery systems with coordinated care,” he says.