Care Transformation Center Blog

The insights, tools, and resources you need to take on population health management

Want more patients to self-manage? Here's what you can do.

by Miles Cottier and Vidal Seegobin December 4, 2019

Editor's note: A version of this post previously ran on The Forum.

Caring for high-risk, polychronic patients accounts for over 18% of US GDP. Yet it's estimated that 70-80% of this population can be supported to self-manage their conditions.

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So you have a post-acute network—now what?

by Carolyn Buys and Monica Westhead November 20, 2019

Efficiency across an episode of care is critical to success under value-based payment models. To manage post-acute outcomes under these programs, many hospitals have convened preferred networks of high-quality post-acute providers.

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How to put trauma-informed care theory into practice

by Darby Sullivan and Tomi Ogundimu November 13, 2019

Trauma-informed care is an essential patient engagement framework to use with vulnerable or at-risk patient populations. Often, trauma and adverse childhood events (ACEs) contribute to the root causes of clinical and social comorbidities and interfere with attempts to support self-management. However, few provider organizations know how to design and implement an effective program. Providers can set patients up for long-term recovery with a model that centers programming on community input and provides expert-led and ongoing staff training.

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Enrollment and graduation aren't just for students: Clear guidelines optimize care management programs

November 6, 2019

The goal of care management is to engage patients in their care and equip them to self-manage their health long-term. This journey inevitably involves two inflection points: care management enrollment and graduation.

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CMS just finalized new discharge planning rules. Here's what you need to know.

by Tripti Rathi and Monica Westhead October 23, 2019

Each year, millions of patients must decide where to receive post-acute care following an inpatient admission.

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How UCSF launched the Trauma Recovery Center and cut costs by one third

by Darby Sullivan and Tomi Ogundimu October 16, 2019

In June, we discussed three key components of trauma-informed care. Some of you emailed us thoughtful feedback about what constitutes the scope of trauma. Specialized care can promote resilience among patients who've endured many types of trauma, including patients who have parents with substance use disorders, refugees from war zones, and survivors of the AIDS epidemic. However, traumatic experiences widely vary, so a one-size-fits-all approach risks re-traumatizing patients and interfering with recovery. Instead, providers should tailor each patient's treatment plan to the type of trauma endured.

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How Intermountain's neonatal telehealth program saved $1.2M, improved care, and secured community hospital revenue.

by Lauren Lawton and Tara Viviani October 9, 2019

Editor's note: A version of this post previously ran on The Growth Channel blog.

Up to 10% of newborns require breathing assistance or extensive resuscitation. While neonatal providers attend biannual resuscitation trainings, skill deterioration is common within months of the course, especially for those who rarely use resuscitation.

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How Hebrew SeniorLife is managing the growing dementia population—and how you can too

by Carolyn Buys and Monica Westhead October 2, 2019

The number of patients with Alzheimer's and other forms of dementia is expected to grow from 5.8 million to 14 million by the year 2050, costing the U.S. health system nearly $800 billion. These patients have twice as many hospital stays as other older adults, and present unique clinical challenges to providers, such as frequent wandering and ED utilization.

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