journal of biomedical informatics
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A Collaborative Approach to Care Coordination: Maccabi case study

Author(s): Pavel Kubu, Rachelle Kaye, Mariana Waksman, Mark N. Blatt, Tony Corrigan

Cost pressures, new payment models, and demographic trends are creating a global economic crisis as health systems struggle to care for an aging population of sicker patients. Funds available for healthcare are constrained, and they’re being wasted by inefficient, uncoordinated healthcare services. Reflecting the importance of collaboration in caring for patients with chronic conditions, nearly 80 percent of the scoring criteria for the National Committee for Quality Assurance’s (NCQA) Recognition Program for Physician Practice Connections (PPC) Patient-Centered Medical Home (PCMH) relate to information sharing and teamwork. New payment models are forcing delivery networks to share the risks and potential cost savings of caring for these patients. By imposing direct or indirect financial consequences, these models incentivize organizations to emphasize prevention, deliver care in the lowest-cost appropriate setting, and reduce readmissions, Emergency Department (ED) visits, acute-care admissions, and bed days of care. Maccabi’s core belief is that all IT investments are business investments that should support strategic priorities and deliver a sustainable advantage to the organization. Among other clinical benefits of collaborative approach to care coordination in Maccabi implementation of Health IT tools supporting care coordination resulted in 13% increase in the number of diabetic patients who had a regular HbA1c and 8% increase in the number of diabetic patients whose HbA1c results indicated that the disease was stable.