Extending the framework to value-based coordination architectures

Extending the framework to value-based coordination architectures

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In this chapter, we discuss the need for extending the modeling and simulation methodology discussed in the book to this point to develop a suite of simulations to study specific approaches to value-based delivery of services. The focus is on coordinated care with the goal of enabling design and development of architectures that treat patients as agents interacting with systems and services that are coordinated using health information networks and interoperable electronic medical records. Success in this direction will contribute to the major global healthcare goal of solving the iron triangle reducing cost while improving quality and increasing access. Our specific goal is to allow organizations such as public health departments, hospitals, and new kinds of organizations (such as ACOs in the United States) to evaluate specific coordinated care strategies, proposed payment models, and potential trade-offs between quality and cost of coordinated care. A range of simulation tools must be developed to support the design of coordination architectures and predict important quality metrics that are applicable to diverse populations.

Chapter Contents:

  • 12.1 Introduction
  • 12.2 Alternative payment models
  • 12.3 Model construction methodology
  • 12.3.1 The crucial role of system-level integration
  • 12.3.2 Personal limitation models
  • 12.4 Family of models approach
  • 12.4.1 Model decomposition and hierarchical design
  • 12.4.2 Top-down design
  • 12.4.3 Level specification
  • Patient modeling
  • Dynamic structure
  • Model test bed, data calibration and validation
  • 12.5 Summary
  • References

Inspec keywords: patient treatment; health care; medical administrative data processing; hospitals; digital simulation

Other keywords: public health departments; simulation tools; value-based service delivery; healthcare; payment models; value-based coordination architectures; patient treatment; hospitals; coordinated care

Subjects: Medical administration

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