Initiative: Innovation Series
ACHP’s Health Plan Innovations in Patient-Centered Care details how community health plans are advancing quality care. The series looks at care management strategies and the role of care management nurses; outlines approaches to transitioning patients from acute care to home settings; and examines how health plans are transforming primary care.
A fragmented delivery system makes it difficult for many patients with chronic illnesses and complex needs to coordinate their care. ACHP looks at how health plans can improve the patient experience through the use of care management nurses who work one-on-one with members.
ACHP plans identified five practices that contribute to program success, helping to promote care coordination and patient engagement in care transitions. Our nonprofit, regional health plans are partnering with physicians, provider practices, and community organizations to improve transitions from acute care to home settings.
Health plans can be invaluable partners in the transformation of primary care, implementing innovative approaches and best practices and developing new payment and reimbursement models. All 17 ACHP member organizations at the time profiled increased quality care, improved patient and/or provider experience and/or reduced costs. Focusing on coordination and continuity of care, and rewarding quality and efficiency, benefits consumers and the entire health care system.