Michigan Market Referral Coordination Initiative (MMRCI): A Commitment to Offering Veterans a VA Option for Specialty Care Needs

Last updated 2022-09-28T18:37:35Z

Many Veterans prefer to receive care within the VA but were unaware of their options. MMRCI has created a market level system covering most of Michigan. This unique approach uses a centralized nurse driven team to manage specialty referrals generated at all Michigan sites, working directly with the Veteran to explore both VA and Community Care options.

Origin:

May 2021, Lieutenant Colonel Charles S. Kettles VA Medical Center (Ann Arbor)

Adoptions:

1 in-progress

Partners:

Specialty Care

Overview

The problem

In 2018 the Mission Act was created in response to prolonged wait time and access to care. After the implementation of the Mission Act there was a significant decrease in interfacility consults within the Michigan Market. Our goals were to retain Veterans within the VA Healthcare System. We wanted to assist with care coordination and to decrease fragmentatio ... In 2018 the Mission Act was created in response to prolonged wait time and access to care. After the implementation of the Mission Act there was a significant decrease in interfacility consults within the Michigan Market. Our goals were to retain Veterans within the VA Healthcare System. We wanted to assist with care coordination and to decrease fragmentation of medical records. The access to Community Care alone did not satisfy all Veteran's medical needs or preference and many Veterans reported they often preferred to stay within the VA system even if they were eligible for Community Care. However, Veterans were often not made aware of the option to stay within the VA system for specialty care, even if it could be provided virtually or through a neighboring VA facility. As a result of this Veteran’s were then sent to the community for specialty care that was available at neighboring VA Michigan Market Medical Centers. See more

The solution

In order to include the Veterans in the specialty referral process and allowing them to make an informational decision on their choice of care, VA implemented the "Referral Coordination Initiative" (RCI) in 2021. In this model, responsibility for referrals was shifted from VA providers to the Referral Coordination Team made up of administrative and clinical ... In order to include the Veterans in the specialty referral process and allowing them to make an informational decision on their choice of care, VA implemented the "Referral Coordination Initiative" (RCI) in 2021. In this model, responsibility for referrals was shifted from VA providers to the Referral Coordination Team made up of administrative and clinical staff. Our Referral Coordination Team is directly responsible for delivering VA care options to our Veterans by ordering labs, obtaining medical records, arranging transportation, and assisting with scheduling within the VA Michigan Market. See more

The results

Veterans within the VA Michigan Market are now offered an informational VA choice for their medical care needs, that provides less care fragmentation when compared to being referred from the VA to the community. Since the inception of MMRCI in May of 2021 the number of Community Care referrals sent out has decreased by 15% for Battle Creek and 16% for Sagina ... Veterans within the VA Michigan Market are now offered an informational VA choice for their medical care needs, that provides less care fragmentation when compared to being referred from the VA to the community. Since the inception of MMRCI in May of 2021 the number of Community Care referrals sent out has decreased by 15% for Battle Creek and 16% for Saginaw. See more

Metrics

Since the adoption of this initiative a grand total of $26,519,706 has been saved in Community Care Costs.

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

There are no successful adoptions for this innovation.

MI: John D. Dingell Department of Veterans Affairs Medical Center (Detroit)

Started adoption on 06/2021.

There are no unsuccessful adoptions for this innovation.

Implementation

Timeline

3 Months

Creation of dedicated MMRCI RN team

Access to other facility CPRS system (EHR Software) and consults

Departments

Administration

Core Resources

Resource type	Resource description
PEOPLE	Clinical Application Coordinator, 2-3 hours total. 2 full time registered nurses, partial effort from Community Care Manager, Group Practice Manager from all facilities.
PROCESSES	Teams Meetings Emails Grand Rounds

Optional Resources

Resource type	Resource description
PEOPLE	Clinical Application Coordinator Registered Nurse Community Care Manager Group Practice Manager
PROCESSES	Consult Management and IFC Consults

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

VA User (Staff Physician) posted 2023-09-27T16:26:51Z

Looking at feasbility to adopt this model of care

Email

Email mary.gorman3@va.gov with questions about this innovation.

About

Origin story

Original team

Mary Gorman

Community Care Chief

Karen McDowell

Community Care Registered Nurse

Richard (RJ) Schildhouse

Deputy Chief of Staff

Mark Hausman

Chief of Staff

Matthew Hendren

Community Care Nurse Manager

Jonathan Parrish

MSA Supervisor

Rebecca Spears

Battle Creek GPM

Meghan Jurek

Saginaw GPM

Marcie Simon-Burrell

Detroit Community Care Chief

Search tags

Access to Care Community Care Continuity of Care Coordinated Care Moving Forward Nephrology Outpatient Care Radiology Rural Health Specialty Care

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