title: Implementation of Care Management: An Analysis of Recent AHRQ Research.
abstract: Care management (CM) is a promising team-based, patient-centered approach "designed to assist patients and their support systems in managing medical conditions more effectively." As little is known about its implementation, this article describes CM implementation and associated lessons from 12 Agency for Healthcare Research and Quality-sponsored projects. Two rounds of data collection resulted in project-specific narratives that were analyzed using an iterative approach analogous to framework analysis. Informants also participated as coauthors. Variation emerged across practices and over time regarding CM services provided, personnel delivering these services, target populations, and setting(s). Successful implementation was characterized by resource availability (both monetary and nonmonetary), identifying as well as training employees with the right technical expertise and interpersonal skills, and embedding CM within practices. Our findings facilitate future context-specific implementation of CM within medical homes. They also inform the development of medical home recognition programs that anticipate and allow for contextual variation.
authors: 1 The RAND Corporation, Boston, MA, USA.|2 University of Utah, Salt Lake City, UT, USA.|3 London School of Hygiene and Tropical Medicine, London, UK.
authors: Andrada
authors: A
authors: Tomoaia-Cotisel
authors: 2 University of Utah, Salt Lake City, UT, USA.|4 VA Geriatric Research, Education, and Clinical Center, Salt Lake City, UT, USA.
authors: Timothy W
authors: TW
authors: Farrell
authors: 5 HealthPartners Institute for Education and Research, Minneapolis, MN, USA.
authors: Leif I
authors: LI
authors: Solberg
authors: 6 New York University School of Medicine, New York, NY, USA.
authors: Carolyn A
authors: CA
authors: Berry
authors: 7 Institute for Family Health, New York, NY, USA.
authors: Neil S
authors: NS
authors: Calman
authors: 8 University of Pennsylvania, Philadelphia, PA, USA.
authors: Peter F
authors: PF
authors: Cronholm
authors: 9 University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors: Katrina E
authors: KE
authors: Donahue
authors: 10 University of Alaska Anchorage, Anchorage, AK, USA.
authors: David L
authors: DL
authors: Driscoll
authors: 7 Institute for Family Health, New York, NY, USA.
authors: Diane
authors: D
authors: Hauser
authors: 11 Indiana University School of Medicine, Indianapolis, IN, USA.
authors: Jeanne W
authors: JW
authors: McAllister
authors: 12 Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors: Sanjeev N
authors: SN
authors: Mehta
authors: 13 Group Health Research Institute, Seattle, WA, USA.
authors: Robert J
authors: RJ
authors: Reid
authors: 14 Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
authors: Ming
authors: M
authors: Tai-Seale
authors: 15 HeathPlus of Michigan, Flint, MI, USA.
authors: Christopher G
authors: CG
authors: Wise
authors: 16 University of Michigan, Ann Arbor, MI, USA.
authors: Michael D
authors: MD
authors: Fetters
authors: 17 University of Colorado Denver School of Medicine, Denver, CO, USA.
authors: Jodi Summers
authors: JS
authors: Holtrop
authors: 18 University of California Berkeley, Berkeley, CA, USA.
authors: Hector P
authors: HP
authors: Rodriguez
authors: 2 University of Utah, Salt Lake City, UT, USA.
authors: Cherie P
authors: CP
authors: Brunker
authors: 19 Penn State College of Medicine, Hershey, PA, USA.
authors: Erin L
authors: EL
authors: McGinley
authors: 2 University of Utah, Salt Lake City, UT, USA.
authors: Rachel L
authors: RL
authors: Day
authors: 2 University of Utah, Salt Lake City, UT, USA.
authors: Debra L
authors: DL
authors: Scammon
authors: 20 Agency for Healthcare Research and Quality, Rockville, MD, USA.
authors: Michael I
authors: MI
authors: Harrison
authors: 20 Agency for Healthcare Research and Quality, Rockville, MD, USA.
authors: Janice L
authors: JL
authors: Genevro
authors: 12 Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors: Robert A
authors: RA
authors: Gabbay
authors: 2 University of Utah, Salt Lake City, UT, USA.
authors: Michael K
authors: MK
authors: Magill
mesh_terms: D003266:Continuity of Patient Care / Q000458:organization & administration*; D006284:Health Plan Implementation / Q000379:methods*; D006801:Humans; D018802:Patient-Centered Care / Q000458:organization & administration*; D011320:Primary Health Care / Q000458:organization & administration*; D014481:United States; D016270:United States Agency for Healthcare Research and Quality
keywords: PCMH; care coordination; care management; implementation; patient-centered medical home; primary care