Dr. Neglia and The Holston Medical Group have established a unique program that cares for acutely ill patients in an ambulatory setting even though their illnesses would qualify for an inpatient hospitalization.

For the past 20 years, the fundamentals of health care delivery have remained largely unchanged. Health plans rely on cost-shifting and utilization management to bend the cost curve, and doctors and hospitals accept lower prices in exchange for increased patient volumes.

Andrew McClure of Senior Whole Health, a Magellan company, discusses his work around aligning quality measurement and improvement and offers insight on what drove the success of this partnership between medical group providers and this special needs health plan.

Describes the implications of Title III of the Bipartisan Budget Act of 2018, which containes a series of landmark provisions for advancing the integration of Medicare and Medicaid and for improving care for persons with complex chronic conditions.

A new care delivery model of providing hospital-level services in the home (sometimes referred to as “home hospitalization” or “hospital at home”) has been launching with pilots at a number of health systems nationally.