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Outcome Pathways
Focusing on Outcomes - Pathways to Health
America has an opportunity to change the business model for health and social service from payment for activities to payment for outcomes.
The current state and federal business model drives the production of service activities across multiple agencies with no measured accountability for specific outcomes and duplicative services. Initiatives across the country are developing strategies to change contractual accountability to the delivery of positive outcomes.
Recent national focus with collaboration from the Health Resources Services Administration, American Academy of Pediatrics, and business and health leaders, have identified three common characteristics of programs effectively improving outcomes;
| 1 | 2 | 3 |
| Identify | Confirm | Measure Outcome |
| Individual Most at Risk | Evidence based intervention | Health and cost savings |
Currently, there is no broad-based strategy to identify those most at risk. Populations at risk for catastrophic outcomes such as pregnancy, diabetes, hypertension, cardiovascular disease, and depression, enter our system through the emergency room only after progression of problems or disease. This results in complex, reactive, and expensive debilitation.
Beginning to change the contracting strategy from service activity to outcomes can be implemented, focusing on those populations most at most extreme risk.
Health Partners Initiative and local collaborators are part of several national sites modeling outcome production utilizing the Pathways model. Pathways have been developed for Medical Homes for women with high risk Pregnancies and Hispanic men who are at high risk for Diabetes. Each Pathway ensures focus on a specific at risk population. Performance measures within the Pathway are linked to payment and ensure that the individual connects to evidence based intervention. Outcome measurements to evaluate health improvement and cost savings are being collected. Health Partners Initiative priorities include:
1. Identify the individual most at risk
2. Confirm the delivery of evidence-based intervention - measure the outcome
3. Simplify contracting, eliminate duplication, and promote efficiency
For more information about the Lincoln Pathways to Health Pilot Project, click here.
Pathways to Health Document Links
NMIS Policies and Standard Operating Procedures Manual
NMISP User Confidentiality Agreement
Behavioral Health Step-by-Step Instruction Guide
Diabetes Step-by-Step Instruction Guide
Pregnancy Step-by-Step Instruction Guide
Pathways Release of Information
Contact Us:
| Wende Baker, Executive Director | Mardy Mead, Project Coordinator |
| wbaker@lincoln.ne.gov | mmead@lincoln.ne.gov |
| 402-441-8144 | 402-441-3495 |
