title: Delivery system reform tracking: a framework for understanding change.
abstract: The health care delivery system is changing rapidly, with providers forming patient-centered medical homes and exploring the creation of accountable care organizations. Enactment of the Affordable Care Act will likely accelerate these changes. Significant delivery system reforms will simultaneously affect the structures, capabilities, incentives, and outcomes of the delivery system. With so many changes taking place at once, there is a need for a new tool to track progress at the community level. Many of the necessary data elements for a delivery system reform tracking tool are already being collected in various places and by different stakeholders. The authors propose that all elements be brought together in a unified whole to create a detailed picture of delivery system change. This brief provides a rationale for creating such a tool and presents a framework for doing so.
authors.affiliation: Kaiser Permanente Institute for Health Policy, USA. laura.a.tollen@kp.org
authors.forename: Laura
authors.initials: L
authors.lastname: Tollen
authors.forename: Alain
authors.initials: A
authors.lastname: Enthoven
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Crosson
authors.forename: Nancy
authors.initials: N
authors.lastname: Taylor
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Audet
authors.forename: Cathy
authors.initials: C
authors.lastname: Schoen
authors.forename: Murray
authors.initials: M
authors.lastname: Ross
mesh_terms: D003153:Community Health Services / Q000458:organization & administration; D003625:Data Collection / Q000379:methods*; D003695:Delivery of Health Care / Q000458:organization & administration*; D006123:Group Practice / Q000458:organization & administration; D018166:Health Care Reform / Q000458:organization & administration*; D006279:Health Maintenance Organizations / Q000458:organization & administration; D006759:Hospital-Physician Joint Ventures / Q000458:organization & administration; D006801:Humans; D007193:Independent Practice Associations / Q000458:organization & administration; D033181:Information Dissemination; D018854:Managed Competition / Q000458:organization & administration; D017146:Models, Organizational; D017063:Outcome Assessment, Health Care / Q000458:organization & administration*; D058991:Patient Protection and Affordable Care Act; D018802:Patient-Centered Care / Q000458:organization & administration; D012052:Reimbursement, Incentive / Q000458:organization & administration*; D020379:Risk Adjustment; D014481:United States