Implementation of Care Management: An Analysis of Recent AHRQ Research

Andrada Tomoaia-Cotisel, Timothy W. Farrell, Leif I. Solberg, Carolyn A. Berry, Neil S. Calman, Peter F. Cronholm, Katrina E. Donahue, David L. Driscoll, Diane Hauser, Jeanne W. McAllister, Sanjeev N. Mehta, Robert J. Reid, Ming Tai-Seale, Christopher G. Wise, Michael D. Fetters, Jodi Summers Holtrop, Hector P. Rodriguez, Cherie P. Brunker, Erin L. McGinley, Rachel L. DayDebra L. Scammon, Michael I. Harrison, Janice L. Genevro, Robert A. Gabbay, Michael K. Magill

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

Care management (CM) is a promising team-based, patient-centered approach “designed to assist patients and their support systems in managing medical conditions more effectively.” As little is known about its implementation, this article describes CM implementation and associated lessons from 12 Agency for Healthcare Research and Quality–sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s). Successful implementation was characterized by resource availability (both monetary and nonmonetary), identifying as well as training employees with the right technical expertise and interpersonal skills, and embedding CM within practices. Our findings facilitate future context-specific implementation of CM within medical homes. They also inform the development of medical home recognition programs that anticipate and allow for contextual variation.

Original languageEnglish
Pages (from-to)46-65
Number of pages20
JournalMedical Care Research and Review
Volume75
Issue number1
DOIs
StatePublished - 1 Feb 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016, © The Author(s) 2016.

Funding

During this process, the TPC team became aware that AHRQ had also concurrently funded four studies of primary care delivery system innovations under a larger program supported by the American Recovery and Reinvestment Act (ARRA; Health and Human Services, 2010). The team invited the primary investigators on these four studies to take part in this cross-study analysis. A second grant, awarded to another study investigator (Magill), also supported this analysis. At this time, the TPC team was expanded to include the participating ARRA instigators and relevant AHRQ personnel (hereafter “the Team”).

FundersFunder number
National Institute of Diabetes and Digestive and Kidney DiseasesP30DK036836
Agency for Healthcare Research and QualityHHSA2902007

    Keywords

    • PCMH
    • care coordination
    • care management
    • implementation
    • patient-centered medical home
    • primary care

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