High-Need Patients’ Goals and Goal Progress in a Veterans Affairs Intensive Outpatient Care Program

Abstract

w) contains supplementary material, which is available to authorized users.

Primary Care Physician Perspectives on the Influence of Patient Values, Health Priorities, and Preferences on Clinical Decision-Making for Complex Patients with Multimorbidity: A Qualitative Study

“… 7 , 8 Innovative, patient-centered care models have arisen that operationalize incorporation of patient values, health priorities and goals, and preferences for older adults with multimorbidity. 9–12 Despite these efforts, clinicians still describe challenges with incorporating these concepts when making care planning decisions for these patients, including difficulty aligning their own priorities with those of patients, experiencing faulty communication with patients, and ambiguous clinical applications of patient values. 11 , 13 , 14 …”

“…7,8 Innovative, patient-centered care models have arisen that operationalize incorporation of patient values, health priorities and goals, and preferences for older adults with multimorbidity. [9][10][11][12] Despite these efforts, clinicians still describe challenges with incorporating these concepts when making care planning decisions for these patients, including difficulty aligning their own priorities with those of patients, experiencing faulty communication with patients, and ambiguous clinical applications of patient values. 11,13,14 In 2010, the largest integrated health system in the United States (US), the Veterans Health Administration (VHA), implemented a patient-centered medical home (PCMH) model nationwide with an enhanced focus on whole personcentered care, including training in patient-centeredness, expanded provider continuity, and comprehensive services for disease management.…”

High-Risk Patient Experiences Associated With an Intensive Primary Care Management Program in the Veterans Health Administration

“…Patient experience, including satisfaction with providers, has been described as a critical component of care quality delivered to high-need, high-cost patients (Zulman et al, 2014). Understanding the short- and long-term effects of intensive management programs on patient experience through relationship building, trust, or patient engagement would help clarify the effects of intensive management programs outside the traditional return on investment or costs (Chang et al, 2018; Hsu et al, 2019; Zulman et al, 2019).…”