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Reforming person-centered care planning for those with multiple conditions is challenged by time constraints, inadequate payment, and workforce availability.

“The US has a growing population of people living with multiple chronic conditions (MCC), yet the health system is ill-designed to meet their needs,” researchers wrote in JAMA Network Open. “Person-centered care planning (PCCP) is an approach to provide comprehensive care that is responsive to the individual to improve health outcomes and increase value.”

Brittany N. Watson, MD, MPH, and colleagues conducted a qualitative study to explore strategies that could be employed to provide PCCP for people living with or at risk for MCC, as well as catalysts and challenges to implement it effectively.

The study included 58 respondents, comprising clinicians, researchers, patients, caregivers, representatives from healthcare payers, practitioners, health systems, advocacy organizations, and professionals from supporting nonprofit and industry organizations.

Supporting PCCP: Themes & Barriers

The researchers identified nine themes via a thematic analysis of responses to the Agency for Healthcare Research and Quality’s Request for Information, including: (1) suboptimal quality of care; (2) person-centered, goal-concordant care; (3) multidisciplinary team-based care and care coordination; (4) prevention across the life course; (5) digital health solutions; (6) workflow; (7) education and self-management support; (8) payment; and (9) achieving community, health system, and payer goals.

These themes identify areas for reform that are necessary to support PCCP, as well as elements of care delivery models toward the same goal, the researchers noted.

Barriers to employing PCCP included time constraints, inadequate payment, and workforce availability and competencies.

Looking Ahead: How to Deliver Person-Centered Care

“Understanding how to effectively provide comprehensive, person-centered care is foundational to improving health outcomes for people living with or at risk for MCC and increasing value in care delivery,” Dr. Watson and colleagues wrote.

The researchers noted that this study emphasizes significant challenges in advancing PCCP across the healthcare system, accentuating the need for alignment in payment, policy, and culture, as well as evidence-based models and strategies for implementation.

“PCCP is central to health care redesign to deliver person-centered care,” the researchers wrote. “Insights gained from this analysis are informing research priorities, dissemination, and implementation efforts to transform care for people living with and at risk for MCC.”