Care Redesign

Critical Component in Transition to Value-Based Accountable Care

Carol Corp. believes meeting the twin challenges of increased access to care and pressure to lower costs requires a fundamental change in the financing and delivery of health care. With its strategies and solutions, Carol offers providers a customized strategic roadmap to drive toward accountable care. Care redesign is an important factor in the transition to accountable care. However, alignment of care redesign with payment redesign strategies is essential to ensure a financially successful and sustainable transition to high-value accountable care.

With its care redesign strategies and solutions, Carol empowers innovative providers in their transition from the traditional volume, encounter-based model to one that rewards high-value and population-based health care.

Care Redesign Product Philosophy

While Carol recognizes that the journey to accountable care will be different from one organization to another, Carol strongly believes there are at least five common elements to successful care redesign and a sustainable transition to accountable care:

A committed, strong leadership model that engages front-line care delivery teams in organized and aligned initiatives that drive toward affordability and quality.
A care delivery model that integrates traditional care management features and designs processes and roles into a team-model with all members practicing at the top of their credentials.
An information management strategy that facilitates risk-stratified population management, integrated into daily practice and ongoing performance measurement.
Technology deployed in alignment with workflow and roles, ensuring that the right information is in the right hands across the continuum of care, facilitating evidence-based practice, efficient care and informed decision making.
Financial operations that support understanding and proactive management of risk-based payment and incentives, at a program and system level.

Care Redesign Process

Carol's care redesign process is comprehensive, providing objectives, care management strategies and integration processes, and implementation tools – including point-of-care information, technology, measurement and reporting tools, change management and communications support.

Carol is a full partner working side-by-side with our clients to identify and install the elements of successful care redesign. In most cases, the Carol care redesign strategy is informed by the Carol Strategy & Assessment phase, which assesses and synthesizes market performance, competitive positioning and the organization's capabilities to manage value-based payment.

During care redesign, Carol works with the client to design and pilot integrated care delivery and care management solutions – marrying evidence-based care with efficient processes and information to produce predictable, high-quality outcomes for specific disease conditions or procedures. Carol conducts an on-site facility process assessment and practice pattern assessment to further refine actionable opportunities for process redesign. Based on analysis and in coordination with the physician and financial leadership, the specific areas of redesign focus are identified and processes are proposed and piloted. The clinical intervention valuation model calculates the predicted cost and impact of the proposed care redesign intervention(s).

The care redesign process creates:

Research based clinical and business rationales for change.
Customized objectives for clinical and business outcomes.
Workflow pathways and staff role definitions that have proven effective through a client pilot stage.
Key metrics, both ongoing operational measures and a plan to measure the impact on cost, quality and patient experience of care redesign strategies.
Defined and documented data and technology requirements.
An implementation guide to support diffusion.

Care Redesign Toolkit

Carol's goal is to ensure that care redesign strategy, tactics and outcomes the support successful execution of Triple Aim goals in a value-based payment environment. Care redesign's focus and implementation are data-driven, and its tools are comprehensive and applicable across the entire continuum of care. The implementation toolkit includes:

Carol Clinical Analytics platform
Carol Clinical Performance Management System