American health care resources are designed and deployed primarily to treat acute illnesses and injuries. As the population has aged, however, the need for health care has shifted from acute conditions toward the chronic conditions of older people. There is a growing mismatch between care that is effective for those with intense but short-term acute problems – and care for those with chronic problems who receive care from multiple providers in multiple settings over a long period of time. As a result, people with chronic conditions, especially those needing complex care, often receive care that is fragmented, incomplete, impersonal, duplicative, inefficient, and expensive. As policy officials grapple with the rising cost of health care, the urgency of finding better care delivery models for this population is paramount – 70 percent of the Medicare budget is expended to care for a minority (10%) of seniors and disabled people with complex and chronic conditions.
One promising approach is to integrate more effectively the multi-dimensional services required by people with complex care needs. Excellence in integration of care requires that care is coordinated across the continuum of care (prevention, primary care, specialty care, emergency department, hospital, post-acute care facility, rehabilitation center, care in the patient’s home, community support services, and nursing home care). Excellence in integration of care requires that all the health professionals and sites of care involved in a patient’s care share information, goals, and an agreed-upon care plan that addresses patients’ goals and preferences for care. Attributes of excellent integrated care include care that is comprehensive, coordinated, efficient, and effective in attaining the patient’s preferred outcomes.
Such integration can occur, however, only with substantial changes in public policy, delivery system organizational structures, payment mechanisms, public awareness, medical research, and professional education and practice patterns. Eventual success depends on our ability to sustain an integrated care strategy that is as multi-dimensional as the problem.
Vision: the Roger C. Lipitz Center for Integrated Health Care will become recognized as the nation’s leading source of health services research to develop policies and identify, test, evaluate, and spread service delivery and payment changes that contribute to excellence in integrated care for adults with complex care needs and prepare leaders and champions of outstanding integrated care systems.
Mission: to develop and contribute to achievement of a 2020 Vision of a High Performance Integrated Care System that ensures financial access to essential services; family-centered coordinated care; alignment of provider incentives for integrated care; information and support for care integration; and commitment to highest standards of quality and performance including preparation of health professionals to lead this transformation.
1. To conduct research to promote high-quality, cost-effective integrated care systems providing comprehensive, coordinated, efficient, and effective care to adults with complex care needs and their families.
2. To help prepare the next generation of scholars, practitioners and administrators to lead the continued integration of care for adults with complex care needs.
3. To disseminate new knowledge on integrated care to those in a position to effect change including policy officials, health care leaders, health professionals, and researchers.
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