Spain: Reinventing chronic care management for the elderly

Ribera Salud Hospital System | Valencia, Spain

Provider type: Public-private municipal health system
Program name: Complex Care Plan

Developed in 2012 to address the needs of the local elderly population, the Complex Care Plan (Plan de Atención al Paciente Crónico) aims to integrate care across the care settings. The program is managed through a local public-private partnership, Ribera Salud, and has resulted in a 27 percent decrease in overall hospital admissions. Key success factors include interdisciplinary primary care teams (clinical and non-clinical), use of standardized electronic health records, and physician bonuses tied to outcomes.