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AMDA Long Term Care Medicine - 2014


307 - The Changing Imperative of Healthcare: Lessons from Montefiore's Pioneer Accountable Care Organization (ACO)


Mar 1, 2014 11:00am ‐ Mar 1, 2014 12:30pm

Standard: $24.00

Description

Accreditation
The American Medical Directors Association (AMDA) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation Statement:
The American Medical Directors Association designates this Internet Enduring Material for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

AMDCP Credit Designation:
This session has been approved for a total of management 1.5 credit hours toward certification as a Certified Medical Director in Long Term Care (CMD).

Session Description:
Montefiore Medical Center, the major teaching affiliate of Albert Einstein College of Medicine, Bronx, New York, was awarded one of 32 Pioneer Accountable Care Organizations (ACOs) by The Centers for Medicare & Medicaid Services (CMS) in 2011. Montefiore’s ACO has led to the development of an increased close and collaborative relationship with several local long-term care facilities; and the development and implementation of novel programs to meet the ACO goals. This session will describe several of these programs, the implementation of an acute care unit in long-term care, executive dysfunction (ED) navigator, congestive heart failure (CHF) program and the development of a robust palliative care service. Montefiore additionally has an extensive electronic database which allows for analysis of performance data of nursing homes related to readmissions which will be also presented in this session.

Learning Objective(s):

  • Review the present limitations to quality behavioral health care and psychotropic medication management in skilled nursing facilities.
  • Understand Medical Behavioral Integration, its role in 'patient-centered' care in nursing facilities, and how it provides a unique backdrop for introducing telepsychiatry to this environment.
  • Understand how to incorporate telepsychiatry into the nursing facility culture; define expectations and outcomes for this new model of care delivery.
  • Suggest alternatives to fee-for-service reimbursement that can sustain the telepsychiatry model over time.

Speaker(s):
Rubina Malik, MD, MS; Amy Ehrlich, MD; Sandra Selikson, MD, CMD; Roy J. Goldberg, MD, CMD; Michael Bogaisky, MD

Disclosure(s):
None

Reference(s):
1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee for service program. NEJM 2009 Apr 2: 360 (14): 1418 -282. Silverstein MD, Qin H, Mercer SQ, et al. Risk factors for 30 –day hospital readmission in patients > 65 years of age. Proc (Bayl Univ Med Cent) 2008 Oct: 21 (4): 363-723. Wiliams EI, Fitton F. Factors affecting early unplanned readmission of elderly patients to hospital. BMJ. 1988 Sept 24: 297 (6651): 784 -74. Bilimoria NM. The forgotten players in ACO development: nursing homes. J Med Pract Manage. 2012 Mar-Apr: 27 (50): 309-11

Speaker(s):

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