3 Features of Effective Care Coordination Agreements
There has been little research on care coordination agreements, or dyads between a primary care physician and a specialty practice, hospital or other healthcare provider. But a new study published in the American Journal of Managed Care describes some features of useful CCAs.
The study outlined two types of CCAs: master service agreements and co-management agreements. Master service agreements include broad agreements about how providers will conduct referrals and transitions of care. Co-management agreements are more specific, as they delineate the division of tasks for the co-management of a particular condition. Many CCAs include elements of both types, according to the study.
Researchers analyzed 15 CCAs among primary care physicians, specialists, hospitals, long-term care providers and community health organizations. Here are three features found to be most useful to those CCAs.
1. Mechanics of referrals. Study participants, including specialist practices and hospitals, said limited access to referrals was often the strongest motivation to initiate a CCA in the first place. Most CCAs analyzed in the study outlined how referrals will be requested and conducted. The more standardized the process, the more consistently partners applied the agreement, according to the study.
2. Co-management duties. Co-management agreements were found in roughly half of the 15 CCAs reviewed in the study and described by all of those organizations as useful. Common elements of co-management agreements include evidence-based care protocols, specifications for proper referral preparation for certain conditions and continuing medical education for primary care physicians on the co-management of specific conditions.
Providers generally developed broad co-management plans for certain health conditions in advance instead of customizing plans for each individual patient, according to the study. For example, providers would list the tests and therapies a primary care provider would provide for a patient before arranging a consultation with a specialist.
3. Co-location arrangements. In some CCAs analyzed in the study, one provider partner had a representative provider who was embedded in the other partner's practice. This was a frequent arrangement among behavior health collaborators in a primary care practice. Study participants said this set-up resulted in "osmosis" learning, as providers shared the same space and had more opportunities for casual interactions.
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