Case Management

Could a Dutch homecare model improve care for U.S. patients?

Case Management Insider, September 15, 2015

A homecare model started in the Dutch city of Almelo is turning heads in the U.S. for its innovative approach to in-home patient care, which not only saves money, but produces high satisfaction rates among patients and staff members, according to the Commonwealth Fund, a private foundation aimed at improving healthcare quality.

Run by the nonprofit Buurtzorg Nederland, this model calls on teams of nurses to assume care for groups of patients in specific neighborhoods. Each team of 10–12 nurses provides all aspects of care to up to 60 patients in each area, from medical care to scheduling physician appointments, coming up with care plans, helping to link patients with community resources, and providing billing support. Nurses work independently without reporting to managers, but they do have coaches who are available to provide support or answer questions.

These self-governing teams require little administrative support—only about 50 staff members work in administration, paying salaries and taking care of other financial tasks, according to the Commonwealth Fund.
The program has grown from one team in 2007 to more than 700 across the country this year. Other countries are also looking into adopting this model or aspects of it, including a program in Michigan that started up with support from Buurtzorg in 2014. Established as a nonprofit in 2015, Buurtzorg USA has four nurses now caring for private pay patients. Future goals are to build the initiative by creating a referral network, which it currently lacks, and to hammer out how to navigate the challenges presented by multiple payers, says the Commonwealth Fund.

The Dutch version of the program has, however, largely proven its success and gotten government backing because organizers have shown that while the program is popular among both patients and nurses, it’s also more efficient than other models in meeting patient needs in less time for less money. Homecare for one patient took an average of 108 hours versus 168 for other organizations over the course of a year. Costs were lower for this care than 62% of competing providers, according to a study of the organization.

Click here to read more about the Buurtzorg model.


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