1. Acute coronary syndrome pathways: alignment with a bundled care reimbursement model
- Author
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Daniel C. Johnson, Pete Fong, Emily Blake Jackson, Julie D. McNeil, Keith Churchwell, John M. Starmer, John A. McPherson, Susan Cortez, Donna Christensen, Sonia L. Scalf, Zachary W. Klint, Carol M. Parsons, Robin Steaban, and Tina French
- Subjects
medicine.medical_specialty ,Acute coronary syndrome ,Best practice ,Episode of Care ,Tertiary care ,Order entry ,Reimbursement Mechanisms ,Ambulatory care ,Health care ,Outpatients ,medicine ,Humans ,Acute Coronary Syndrome ,Angioplasty, Balloon, Coronary ,Intensive care medicine ,Reimbursement ,Inpatients ,Evidence-Based Medicine ,business.industry ,Evidence-based medicine ,medicine.disease ,Critical Pathways ,Medical emergency ,Patient Care ,Cardiology and Cardiovascular Medicine ,business - Abstract
Changes in public policy, population demographics, and market dynamics are spurring innovative approaches to value-based care. Annually, hospitalizations for Acute Coronary Syndromes (ACS) account for a substantial proportion of healthcare expenditures in the United States. Vanderbilt University Medical Center has developed a framework to deliver comprehensive care incorporating inpatient and outpatient care teams for patients with ACS under an episode-based, bundled reimbursement model for a term of 6 months. As such, a value-oriented pathway was created with the goals of (1) optimizing patient outcomes following ACS; (2) minimizing complications from the treatment of ACS; and (3) reducing costs of healthcare related to the treatment of ACS. In a tertiary care academic medical system receiving patients from multiple facilities involving multiple providers, standardization of care by using practice guidelines and evidence-based data coupled with a robust computerized provider order entry system provides a unique opportunity to produce a "best practice" algorithm for treating patients presenting with ACS. Presented in this study are in-hospital and postdischarge care pathways for treating a diverse group of patients presenting with ACS to our institution.
- Published
- 2011