This chapter discusses a simulation framework to guide design, development, and evaluation of architectures for pathways-based coordination of care. A simulation model was presented that exemplifies this framework and is intended to predict ROI for implementing pathways-based coordination as well its sustainability over the long term. The model does not include dimensions such as client risk characteristics, the referral source of clients to the coordination program, the effect of incentives on service workers' performance, and alignment of pathways with payments. Including these dimensions would be needed to increase the predictive capability to address questions about pathways that are important for their implementation in value-based healthcare.

Chapter Contents:

• 7.1 Introduction
• 7.2 Simulation model framework
• 7.3 Evaluation framework for coordinated care architectures
• 7.4 Pathways home care coordination in low birth weight prevention
• 7.4.1 Model description
• 7.4.2 Return on investment
• 7.4.3 Sustainability
• 7.4.4 The model as an exemplar of value-based HDSoS
• 7.5 Conclusions and recommendations
• References
• Appendix A.1 MS4 Me code and graphical displays for the CHAP ROI model

Inspec keywords: cost-benefit analysis; medical administrative data processing; health care

Other keywords: ROI prediction; pathways-based care coordination simulation; sustainability; value-based healthcare

Subjects: Medical administration