The Opportunity

Poorly coordinated care may lead to negative, unintended consequences including medication errors and preventable hospital admissions.^{1, 2} The Agency for Healthcare Research and Quality (AHRQ) estimates that adverse medication events cause more than 770,000 injuries and deaths each year, more than half of which affect those over age 65.³ The cost of treating patients harmed by these events is estimated at $5 billion annually.⁴ For example, individuals with chronic conditions whose care relies on effective coordination through a complex healthcare system, managed by multiple providers in multiple settings, often find it difficult to navigate the system of care. For these individuals, the difficulty in managing these multiple care transitions can contribute to poor outcomes and hospitalizations. In 2010, preventable hospital admissions accounted for nearly $32 billion of costs for adults with selected chronic and acute diseases.⁵ The coordination of care is essential to reduce preventable hospitalizations, improve patient outcomes, and lower costs in today’s healthcare system.

A variety of tools and approaches, when leveraged, can improve care coordination. For instance, care coordination is positively associated with patient- and family-reported receipt of family-centered care, resulting in greater satisfaction with services, lower financial burden, and fewer emergency department visits.⁶ Additionally, electronic health records (EHRs) can reduce unnecessary and costly duplication of patient services.⁷ Patient education and the reconciliation of medication lists could also reduce costs by decreasing the number of serious medication events.⁸ The Institute of Medicine (IOM) indicates that care coordination initiatives such as patient education and the development of new provider payment models could result in an estimated $240 billion in savings.⁹

NQF Related Work

• Care Coordination Measures – 2017
• Person and Family Centered Care Final Report Phase III – 2017
• PFCC Final Report Off Cycle Review – 2016
• Person and Family Centered Care Phase II – 2016
• Person and Family Centered Care Phase I – 2015
• Priority Setting for Healthcare Performance Measurement: Addressing Performance Measure Gaps in Care Coordination – 2014
• NQF-Endorsed Measures for Care Coordination Phase 3 – 2014
• Priority Setting for Healthcare Performance Measurement: Addressing Performance Measure Gaps in Person-Centered Care and Outcomes – 2014

Stay Connected

For more information, please contact patientexperience@qualityforum.org.

1 Schultz EM, Pineda N, Lonhart J, et al. A systematic review of the care coordination measurement landscape. BMC Health Serv Res. 2013;13:119.

2 Vogeli C, Shields AE, Lee TA, et al. Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med. 2007;22 (Suppl 3):391-395.

3 Budnitz DS, Pollock DA, Weidenbach KN, et al. National surveillance of emergency department visits for outpatient adverse drug events. JAMA. 2006;296(15):1858-1866.

4 AHRQ. Reducing and Preventing Adverse Drug Events to Decrease Hospital Costs. Rockville, MD: AHRQ; 2001. Research in Action Pub No. #01-0020. Available at http://www.ahrq.gov/qual/aderia/aderia.html. Last accessed March 2017.

5 Torio CM, Elixhauser A, Andrews RM. Trends in Potentially Preventable Admissions among Adults and Children, 2005-2010. Rockville, MD: AHRQ; 2013.

6 Turchi RM, Antonelli RC, Norwood KW Jr, et al. Patient-and family-centered care coordination: a framework for integrating care for children and youth across multiple systems. Pediatrics. 2014; 133(5):e1451-e1460. 

7 Congressional Budget Office (CBO). Evidence on the Costs and Benefits of Health Information Technology. Washington, DC: CBO; 2008. Available at http://www.cbo.gov/sites/default/files/cbofiles/ftpdocs/91xx/doc9168/05-20-healthit.pdf. Last accessed March 2017.

8 Pronovost P, Weast B, Schwarz M, et al. Medication reconciliation: a practical tool to reduce the risk of medication errors. J Crit Care. 2003;18(4):201-205.

9 Institute of Medicine (IOM). The Healthcare Imperative: Lowering Costs and Improving Outcomes - Workshop Series Summary. Washington, DC: National Academies Press; 2010.