The Issue
There are several different approaches to promoting patient-centered care: creating medical homes, helping patients to become partners in treatment decisions, and instituting payment reforms that enable doctors to be reimbursed for time spent counseling patients about healthy behaviors, for e-mail consultations, and for coordinating care with other providers. Little is known, however, about how health care organizations choose their approach and set goals. In this Commonwealth Fund–supported study, researchers interviewed health plan leaders and providers in Washington State, a leader in patient-centered innovation.
What the Study Found
All 20 organizations contacted shared the goals of promoting patient-centered care, but they were also focused on controlling costs, improving quality, and sustaining their business models. Among the key criteria used to select a patient-centered care model were chronic disease management services and integrated health information technology systems. The following were seen as barriers to innovation: inertia, lack of resources, fee-for-service payment, and regulatory limits. Having strong leaders and an adaptive culture can overcome such barriers and facilitate innovation, respondents said.
Conclusions
"The process of innovation is heavily dependent on organizational culture and leadership," the authors conclude. "Policymakers can improve the pace and quality of patient-centered innovation by setting targets and addressing conditions for innovation." These conditions include leadership training, smart regulation, and interorganizational cooperation.
