The Impact of Integrated Case Management on Health Services Use and Spending Among Nonelderly Adult Medicaid Enrollees

Medicaid plans, whose patients often have complex medical, social, and behavioral needs, seektools to effectively manage enrollees and imprive access to quality care while containing costs. 

The aim of this study is to examine the effects of an integrated case management (ICM) program operated by a Medicaid managed care plan on health service use and spending for nonelderly, non-pregnant adults. 

Integrating terminology for integrated care

The plan is to transform a fragmented and largely uncoordinated model into a multidimensional care model that integrates social care systems with health care systems. To achieve this integration successfully, a strong conceptual framework must be constructed, in which terminology will play an important part. Since language mediates a particular vision of reality, when creating a new care model it seems important to focus on terminology. 

Effective Organizational Leadership in the Implementation of Integrated Care; Lessons from 9 cases in the iCoach Project

Policy makers in many countries are encouraging the development of integrated care strategies and the development of new models of integrated care. These new models require changes at a clinical or service level, organizational level and system level with strong leadership necessary at all three levels. Despite the key role of leadership in these efforts, there has been only limited study of what organizational leadership approach is successful in different contexts for integrated care. 

Developing accountable care systems: lessons from Canterbury, New Zealand

The health system in Canterbury, New Zealand, has undertaken a significant programme of transformation over the past decade. As a result of the changes, the health system is supporting more people in their homes and communities and has moderated demand for hospital care, particularly among older people. Change was achieved through developing a number of new delivery models, which involve better integration of care across organisational and service boundaries, increased investment in community-based services, and strengthening primary care. The experience in Canterbury offers useful lessons for the NHS in terms of how to redesign care in this way. Key approaches ...

Centers of excellence in healthcare institutions: what they are and how to assemble them

Centers of excellence have the ability to dramatically enhance the depth and breadth of healthcare services available in communities. Given the numerous mutual benefits afforded by this delivery model, it is hoped that the light shed by this article will help healthcare providers better understand centers of excellence and be more capable and confident in associated development initiatives, affording greater opportunities for themselves and their patient populations. 

Social accountability in primary health care in West and Central Africa: exploring the role of health facility committees

Social accountability has been emphasised as an important strategy to increase the quality, equity, and responsiveness of health services. In many countries, health facility committees (HFCs) provide the accountability interface between health providers and citizens or users of health services. This article explores the social accountability practices facilitated by HFCs in Benin, Guinea and the Democratic Republic of Congo. 

Financing Long-Term Services and Supports: Ideas From Singapore

Financing long-term services and supports (LTSS) for the elderly is a pressing issue in the Unites States with reforms of long-term care insurance (LTCI) presently being explored. Singapore, with 65% of residents aged 40 to 83 covered by basic LTCI, including 22% with supplementary LTCI plans, has the highest voluntary LTCI rate in the world. This article contributes to the discourse by presenting the case of LTSS financing in Singapore. 

An Evaluation of the Role of an Intermediate Care Facility in the Continuum of Care in Western Cape, South Africa

A comprehensive primary healthcare (PHC) approach requires clear referral and continuity of care pathways. South Africa is a lower-middle income country (LMIC) that lacks data on the role of intermediate care (IC) services in the health system. This study described the model of service provision at one facility in Cape Town, including reason for admission, the mix of services and skills provided and needed, patient satisfaction, patient outcome and articulation with other services acrross the spectrum of care 

The theory and practice of integrative health care governance: The case of New Zealand’s alliances

The purpose of this paper is to outline the theory and practice of governance for integrated care, using the case of New Zealand´s healthcare alliances.

Integrated care in practice – the South Eastern Sydney experience

The purpose of this paper is to describe the recent efforts of a large publicly funded health care organisation in Sydney, Australia to implement integrated care (IC) "at scale and pace" in the messy, real-world context of a District Health Service. This paper highlights key factors relating to implementation and evaluation of a local IC Strategy in the real world.