NURS FPX 6612 Assessment 4

NURS FPX 6612 Assessment 4

Cost Savings Analysis 

Name

NURS-FPX6612: Health Care Models Used in Care Coordination 

Capella University 

Instructor’s Name

 August 27th, 2024

Cost Savings Analysis

In current medical care, appropriate and efficient organization of care is not only required from the clinical standpoint but also the financial standpoint. This assessment presents the outcome of the senior care coordinator’s assessment of the impacts of care coordination, and the cost-related benefits of better healthcare services that result from the implementation of health information technology (HIT) are highlighted (Lasater et al., 2021). This analysis is aimed at providing an outline of how special efforts to achieve care coordination can lead to a reduction of cost in the overall healthcare system by reviewing sectors where efficient care coordination has the potential to yield positive outcomes for the patient, data integrity, and minimize wastage.

Spreadsheet

As can be seen from the table below, there is a detailed analysis showing the cost savings brought over by enhanced care coordination in different healthcare activities. It includes some specific activities where strategy change brings obvious savings of money; the annual expense at present; and savings in the next few years; detailing how these savings apply to every part.

Cost-Saving Elements

Current Annual Cost

Anticipated Savings

Reduced Hospital

Readmissions

$6,000,000

$1,7500,000

Decreased Emergency

Room Visits

$4,000,000

$700,000

Improved Medication

Management

$3,000,000

$600,000

Enhanced Chronic

Disease Management

$2,000,000

$1,250,000

The narrow format of the spreadsheet exhibited a highly detailed breakdown of the quantitative work which evidences that improved care co-ordination strategies can translate to massive cost-savings across numerous sectors of operation in healthcare. Specifically, increased patient awareness and their control of condition follow-up have contributed to a significant 30% reduction in hospital readmissions thereby saving $1,7500,000. This drop also suggests reducing the number of costly readmissions to the hospital as well as better post-discharge patient care. As such, enhancements in the reach of first-line and steady health conditions’ control similarly led to a $700,000 reduction in ER utilization rates by 30%. These cost savings are achieved through early intervention of diseases in cheaper healthcare facilities as opposed to emergency healthcare services. The data of spreadsheets also illustrates that the integrated approach in chronic diseases and medications is beneficial regarding the actual treatment of patients and costs reduction.

 The hospital has managed to minimize prescription errors by improving the elements of the Reconciliation of medications thus gradually eliminating $600,000 of cost associated with the avoidance of adverse drug events. Moreover, through effective control of the exacerbations of chronic diseases through the implementation of integrated care planning and regular follow-up, the treatment of chronic diseases has been enhanced, and $1,250,000 has been gained. Each of the points highlighted in the data underlines the need to finance efficient coordination of care in enshrine considerable savings on the overall costs while at the same improving the quality of delivery of health care.

Care Coordination Can be Cost-saving

Coordinated treatment is gradually gaining recognition as one of the effective strategies in eradicating cases of duplicated services, increasing patient satisfaction, and offering easier means of offering services to reduce costs in health facilities (Willink et al., 2020). This strategy is predicated on several underlying presumptions, including the following: showing that the lack of proper exchange of information between different caregivers often leads to disjointed care, showing that disjointed care raises the possibility of inefficiencies and mistakes; and showing that inter-professional working can reduce costs at the same time as enhancing quality.

The fact that claim complexity is associated with reduced expenses is another facet of care coordination responsibility: readmissions are one of the primary mechanisms through which the follow-up of care coordination can reduce expenditure (Proctor et al., 2022). Studies constantly indicated that effective teamwork among different types of healthcare practitioners and between the inpatient and outpatient services helps to prevent unnecessary readmissions significantly. This is normally done through daily check-ups and ensuring that patients understand and follow the necessary instructions during their post-discharge treatment; these are some of the critical steps that minimize complications that might lead to re-admission of the patient to the hospital.

This is yet another major saver since the trying has decreased on ER visits. To minimize the likelihood of expending a large amount of resources on emergent care, care coordination means allowing patients to have access to outpatient care, and services for the management of chronic conditions and acute care in regulated settings. The care coordinators ensure proper and efficient treatment of ailments that accompany chronic conditions, diseases, or infections that do not require immediate medical attention. The other benefit of rational medication management as influenced by care coordination is the achievement of considerable savings (Piña et al., 2021). This procedure involves ensuring that all prescription medicines prescribed within various therapeutic settings are necessary, appropriate, and non-interacting. One such component of this process is medication reconciliation where people look for the cross-drug interactions and, more often, for the unnecessary duplication of prescriptions. This improves the general health of patients and can counteract costly medication side effects.

Co-ordinate care might be another place that could save money, particularly in the usefulness of the diagnosis and treatment processes. One must be able to stop unnecessary repeats through the use of a central database on a patient’s test and the procedures that were done to him or her (Klaehn et al., 2022). This means that the direct costs of the expensive tests that are not necessary are reduced whilst at the same time reducing the number of potentially dangerous experiments that the patient undergoes.

Care Coordination Improves Health Consumerism and Outcome 

Care coordination enables patients through participation and communication that overarches health consumerism. The care coordinators are useful when they provide patients with proper information and help them, as this makes patients more suitable for selecting a path of treatment (Connor et al., 2023). For example, there is always a chance to reduce worry and raise contentment when care coordinators help patients grasp the distinctive features of their diseases and dwell on the available treatment options.

In the same regard, care coordination ensures that patients will have better access to the appropriate medical care that they require. Such can be done through the reduction of waiting time, proper scheduling of appointments, and syncing of services from various providers (Simpson et al., 2022). For instance, a care coordinator may request that the patient be given consecutive appointments to take care of his or her transportation needs by attending different appointments with different specialists.

More access also ensures that timely diagnosis and treatment are achieved along with frequent chronic disease follow-ups and overall successful reduction of complications as well as halting of the evolution of the disease. This structured and sensible access keeps going, to ensure and deal with constant treatment for the necessary management of long-term health disorders and to avert heavy health risks (Velasquez et al., 2022). Clinically significant benefits are evidencing the efficacy and satisfaction derived by the patient when they are empowered through package integrated care. Integrate care models decrease ER utilization and hospitalization particularly among patients with chronic illness as research shows. This is so that rather than attending to probable health complications once they have developed, these models ensure that patients get comprehensive, continuing care.

Care Coordination Efforts Can Enhance the Collection of Evidence-Based Data

Coordination is at the heart of the Patient-Centered Medical Home (PCMH) model of care delivery. It elevates the level of decision-making by ensuring decisions are made from the best data possible hence increasing the standard of care to the patients and also increasing the chances of collecting all patient information (Norcross et al., 2019). Care coordination within the setting of a PCMH therefore involves the purposeful assimilation of patient data every time he or she accesses some section in the healthcare system. A full patient profile ranging from medical records, treatment efficacy, behavior profile, and results may also be collected as a result of this systematic approach. PCMH guarantees that all the relevant patient information is documented and collected systematically and nondispersive through an organized care coordinator for patients’ communication and contacts with different specialties and services. The conduct of this detailed data collection is important in creating a strong database that will aid clinical decision-making.

PCMH enables healthcare workers to spend more time assisting each patient in the development of the specific treatment plan because patients’ data are assembled and analyzed and this leads to higher quality of care (Vucic et al., 2022). For example, by employing the information on patient data, collected during the long-term investigation, the healthcare specialists can reveal the tendencies and estimate the probable future state of health to introduce the measures of prevention. Besides, in this model, data on the outcomes of care interventions and the alteration of strategies as required will result in continued upgrading of the care. By having cyclic approaches to improve the care delivery enhancing the outcomes, this ensures that it aligns with the existing evidence-based practices.

The nature of the PCMH model demonstrates a causal relationship between the advances in evidence-based data gathering and coordinated care. The care coordinators engage themselves in documenting every interaction as well as the outcome of the processes that a patient undergoes in the multiple care processes (Saunders et al., 2020). This leads to the creation of a wealth of data that is invaluable for ongoing research as well as improvement projects. This data-driven approach is helpful to support the individual patient care planning and develop the culture of continuous clinical practices’ evaluation and enhancement on the evidence base.

The PCMH paradigm logically puts forward much on a position that better data leads to better results and decisions (Mackay et al., 2023). Thus, the PCMH model plays a huge role in enhancing the quality of health care since it increases the range and quality of information as a result of the intensification of joint efforts in the field of comprehensive care. The contemporary healthcare systems in which information is recognized as one of the basic resources for improving the quality of patients’ treatment and organization, this relationship highlights the critical importance of care integration.

Conclusion

It becomes evident that proper care coordination can reduce the cost of healthcare significantly and also enhance the quality of patients’ care. The data presented clearly show that cost-improvement opportunities directly connected with important fields are indeed ways to achieve considerable cost reductions. These savings demonstrate the importance of investment in a robust care coordination system and its ability to be financially sustainable (Pitsillidou et al., 2021). Such systems show that care coordination occupies a strategic position in the never-ending quest for optimizing health care delivery as they ensure financial viability in addition to improving patient status. The leadership of healthcare organizations should expect constant improvement in clinical as well as financial results due to the improvement of these coordination techniques, which in turn will create a leaner and sustainable healthcare system.

References

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Klaehn, A. K., Jaschke, J., Freigang, F., & Arnold, M. (2022). Cost-effectiveness of case management: a systematic review. The American Journal of Managed Care, 28(7), e271–e279. https://doi.org/10.37765/ajmc.2022.89186

Lasater, K. B., Aiken, L. H., Sloane, D., French, R., Martin, B., Alexander, M., & McHugh, M. D. (2021). Patient outcomes and cost savings associated with hospital safe nurse staffing legislation: an observational study. BMJ open, 11(12), e052899. https://doi.org/10.1136/bmjopen-2021-052899

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Proctor, S. L., Gursky-Landa, B., Kannarkat, J. T., Guimaraes, J., & Newcomer, J. W. (2022). Payer-level care coordination and re-admission to acute mental health care for uninsured individuals. The Journal of Behavioral Health Services & Research, 49(3), 385–396. https://doi.org/10.1007/s11414-022-09789-1

Piña, I. L., Allen, L. A., & Desai, N. R. (2021). Managing the economic challenges in the treatment of heart failure. BMC Cardiovascular Disorders, 21(1), 612. https://doi.org/10.1186/s12872-021-02408-5

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Saunders, G. H., Christensen, J. H., Gutenberg, J., Pontoppidan, N. H., Smith, A., Spanoudakis, G., & Bamiou, D. E. (2020). Application of big data to support evidence-based public health policy decision-making for hearing. Ear and Hearing, 41(5), 1057–1063. https://doi.org/10.1097/AUD.0000000000000850

Velasquez, D. E., Mecklai, K., Plevyak, S., Eappen, B., Koh, K. A., & Martin, A. F. (2022). Health system-based housing navigation for patients experiencing homelessness: A new care coordination framework. Healthcare, 10(1), 100608. https://doi.org/10.1016/j.hjdsi.2021.100608

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Willink, A., Davis, K., Johnston, D. M., Black, B., Reuland, M., Stockwell, I., Amjad, H., Lyketsos, C. G., & Samus, Q. M. (2020). Cost-effective care coordination for people with dementia at home. Innovation in Aging, 4(2). https://doi.org/10.1093/geroni/igz051