As more and more individuals access ongoing care, states need to employ strategies to ensure patients receive high-quality services while keeping costs low. Given the high cost of institutionalized care, states should prioritize community-based care in order to:
We’ve outlined three quality improvement strategies in healthcare to help states achieve these outcomes.
LTSS is not one-size-fits-all; each patient has unique and dynamic health challenges that states need to address. This is why initial and ongoing patient assessments are crucial in determining which services patients will need throughout their course of care. The benefits of this are twofold:
For example, a patient might have vision and mobility challenges that make it difficult for them to run errands outside their home, but they are almost fully independent within their home. In this case, it would make more sense for them to receive in-home care, rather than fully institutionalized care. This strategy preserves the patient's independence while also avoiding the expense of long-term residency in a care facility.
An individual’s overall health includes much more than what goes on in the doctor’s office. Their health is also influenced by social, economic and community factors, known as social determinants of health. These external factors are some of the most important components in assessing a patient’s ability to stay within their communities.
For example, does this patient have a reliable way to get around without a car or license? In rural communities, public transportation might be minimal or nonexistent. This can influence a patient’s ability to attend appointments or pick up prescriptions, increasing the risk of non-adherence.
Other examples of social determinants of health include:
Although these factors might not be immediately apparent in a doctor’s office, they are some of the most important influences on a patient’s ability to remain within their community. Therefore, addressing these needs with wraparound social and medical services is key in improving the quality of LTSS care.
Identifying areas to improve state LTSS is a lot easier with data. This is why it’s crucial to collect and analyze LTSS patient data regarding both utilization and quality of care.
This includes qualitative and quantitative data, such as:
These findings can then be cross-examined against factors such as individual diagnoses, location, provider and overall compliance to identify trends in quality and utilization.
With these insights, states can improve LTSS quality through tactics such as provider training or community program development. For example, if one provider network seems to provide an inflated number of institutional care plans for their patients, states can provide training to teach those providers community-based alternatives for addressing patient needs.
Overall, states’ main priority in increasing the quality of LTSS should be increasing the community tenure of patients.
As America’s population ages — and demand for LTSS increases — these tactics will only become more important. By implementing the strategies outlined above sooner rather than later, states will be in a better position to anticipate and react to these changes.
Since 1985, KEPRO has helped more than 20 million members lead healthier lives through clinical expertise, integrity and compassion. KEPRO was founded by physicians and clinical expertise is at the core of our organization.